How much rates vary
Facilitymedian $34 · 10th to 90th $26 to $145Professionalmedian $28 · 10th to 90th $22 to $45
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 $21.88 Median $25.12 Typical High $28.18 | Facility | None | $21.88 | $25.12 | $28.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $21.88 Median $25.12 Typical High $36.31 | Professional | None (both parts) | $21.88 | $25.12 | $36.31 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $25.12 Median $26.92 Typical High $33.88 | Professional | None (both parts) | $25.12 | $26.92 | $33.88 |
BCBS Texas Setting Facility Modifier None Typical Low $44.67 Median $100.00 Typical High $177.83 | Facility | None | $44.67 | $100.00 | $177.83 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $23.99 Median $28.84 Typical High $35.48 | Professional | None (both parts) | $23.99 | $28.84 | $35.48 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $28.18 Median $32.36 Typical High $33.11 | Professional | None (both parts) | $28.18 | $32.36 | $33.11 |
Christus Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $29.51 Typical High $50.12 | Professional | None (both parts) | $24.55 | $29.51 | $50.12 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $32.36 Median $35.48 Typical High $41.69 | Professional | None (both parts) | $32.36 | $35.48 | $41.69 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $194.98 | $194.98 | $194.98 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $26.30 Typical High $35.48 | Facility | None | $24.55 | $26.30 | $35.48 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $21.88 Median $25.12 Typical High $37.15 | Professional | None (both parts) | $21.88 | $25.12 | $37.15 |
Molina Setting Professional Modifier None (both parts) Typical Low $13.49 Median $14.45 Typical High $19.50 | Professional | None (both parts) | $13.49 | $14.45 | $19.50 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $30.90 Median $44.67 Typical High $67.61 | Professional | None (both parts) | $30.90 | $44.67 | $67.61 |
Providence Setting Facility Modifier None Typical Low $26.30 Median $31.62 Typical High $38.90 | Facility | None | $26.30 | $31.62 | $38.90 |
Providence Setting Professional Modifier None (both parts) Typical Low $24.55 Median $28.84 Typical High $50.12 | Professional | None (both parts) | $24.55 | $28.84 | $50.12 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $32.36 Typical High $45.71 | Professional | None (both parts) | $25.12 | $32.36 | $45.71 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None (both parts) | $32.36 | $32.36 | $32.36 |
16 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 |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $11.75 Median $12.59 Typical High $13.49 | Facility | 52 · Reduced service | $11.75 | $12.59 | $13.49 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $28.18 Median $28.84 Typical High $30.20 | Facility | AF · Specialist physician | $28.18 | $28.84 | $30.20 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $21.38 Median $21.88 Typical High $22.91 | Facility | HO · Master's level | $21.38 | $21.88 | $22.91 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $23.99 Median $24.55 Typical High $25.70 | Facility | TD · Registered nurse | $23.99 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $12.59 Typical High $15.49 | Professional | 52 · Reduced service | $11.75 | $12.59 | $15.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $26.92 Median $31.62 Typical High $31.62 | Professional | 25 · Same-day visit | $26.92 | $31.62 | $31.62 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | Q6 · Substitute physician, paid per time | $31.62 | $31.62 | $31.62 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | SA · Nurse practitioner | $31.62 | $31.62 | $32.36 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 26 · Professional part | $28.18 | $28.18 | $28.18 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $11.75 Median $12.59 Typical High $13.49 | Facility | 52 · Reduced service | $11.75 | $12.59 | $13.49 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $28.18 Median $28.84 Typical High $30.20 | Facility | AF · Specialist physician | $28.18 | $28.84 | $30.20 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $21.38 Median $21.88 Typical High $22.91 | Facility | HO · Master's level | $21.38 | $21.88 | $22.91 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $23.99 Median $24.55 Typical High $25.70 | Facility | TD · Registered nurse | $23.99 | $24.55 | $25.70 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $35.48 Median $79.43 Typical High $102.33 | Professional | 25 · Same-day visit | $35.48 | $79.43 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $12.59 Typical High $14.79 | Professional | 52 · Reduced service | $11.75 | $12.59 | $14.79 |
Moda Health Setting Professional Modifier 76 · Repeat, same provider Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 76 · Repeat, same provider | $60.26 | $60.26 | $60.26 |
Where Texas sits
The same service costs 2.5 times more in Alaska than in New York. 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· 41st of 51
$28.84
AK $60.26NY $23.99
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.