How much rates vary
Facilitymedian $28 · 10th to 90th $12 to $56Professionalmedian $13 · 10th to 90th $10 to $21
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $9.12 Median $11.48 Typical High $12.59 | Facility | None | $9.12 | $11.48 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $17.78 | Professional | None | $9.12 | $11.75 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $13.49 Typical High $17.38 | Professional | None | $10.47 | $13.49 | $17.38 |
BCBS Texas Setting Facility Modifier None Typical Low $13.80 Median $37.15 Typical High $67.61 | Facility | None | $13.80 | $37.15 | $67.61 |
BCBS Texas Setting Professional Modifier None Typical Low $9.55 Median $12.02 Typical High $18.20 | Professional | None | $9.55 | $12.02 | $18.20 |
Baylor Scott & White Setting Professional Modifier None Typical Low $10.47 Median $15.14 Typical High $19.50 | Professional | None | $10.47 | $15.14 | $19.50 |
Christus Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $12.59 Typical High $20.42 | Professional | None | $9.55 | $12.59 | $20.42 |
Health Smart Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $54.95 | Professional | None | $14.79 | $16.60 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $10.47 Median $14.79 Typical High $46.77 | Facility | None | $10.47 | $14.79 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $9.12 Median $11.75 Typical High $19.05 | Professional | None | $9.12 | $11.75 | $19.05 |
Molina Setting Professional Modifier None Typical Low $2.00 Median $11.22 Typical High $12.30 | Professional | None | $2.00 | $11.22 | $12.30 |
Oscar Health Setting Professional Modifier None Typical Low $11.75 Median $21.38 Typical High $33.88 | Professional | None | $11.75 | $21.38 | $33.88 |
Providence Setting Facility Modifier None Typical Low $10.47 Median $14.45 Typical High $17.38 | Facility | None | $10.47 | $14.45 | $17.38 |
Providence Setting Professional Modifier None Typical Low $9.55 Median $12.59 Typical High $20.42 | Professional | None | $9.55 | $12.59 | $20.42 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $77.62 | Facility | None | $56.23 | $58.88 | $77.62 |
United Setting Professional Modifier None Typical Low $9.55 Median $12.88 Typical High $18.20 | Professional | None | $9.55 | $12.88 | $18.20 |
Wellpoint Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 25 · Same-day visit | $8.91 | $12.59 | $14.79 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $10.47 Median $11.75 Typical High $12.30 | Professional | 59 · Distinct service | $10.47 | $11.75 | $12.30 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 93 · Audio-only telehealth | $10.96 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier CG · Policy criteria applied Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | CG · Policy criteria applied | $16.60 | $16.60 | $16.60 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | SA · Nurse practitioner | $14.79 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier SE · Publicly funded program Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | SE · Publicly funded program | $13.80 | $13.80 | $13.80 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $15.14 Median $23.44 Typical High $48.98 | Professional | 25 · Same-day visit | $15.14 | $23.44 | $48.98 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $12.02 Median $30.90 Typical High $30.90 | Professional | 59 · Distinct service | $12.02 | $30.90 | $30.90 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | G0 · Stroke telehealth | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | GQ · Store-and-forward telehealth | $29.51 | $29.51 | $29.51 |
Where Texas sits
The same service costs 2.8 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 44th of 51
$12.59
AK $31.62DC $11.48
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.