How much rates vary
Facilitymedian $98 · 10th to 90th $72 to $355Professionalmedian $72 · 10th to 90th $54 to $112
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 $61.66 Median $64.57 Typical High $70.79 | Facility | None | $61.66 | $64.57 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $107.15 | Professional | None | $60.26 | $69.18 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $85.11 | Professional | None | $54.95 | $72.44 | $85.11 |
BCBS Texas Setting Facility Modifier None Typical Low $102.33 Median $234.42 Typical High $416.87 | Facility | None | $102.33 | $234.42 | $416.87 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $95.50 | Professional | None | $58.88 | $70.79 | $95.50 |
Baylor Scott & White Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $109.65 | Professional | None | $64.57 | $85.11 | $109.65 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $104.71 | Professional | None | $61.66 | $72.44 | $104.71 |
Health Smart Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $104.71 | Professional | None | $77.62 | $87.10 | $104.71 |
Lucent Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $97.72 | Facility | None | $64.57 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $104.71 | Professional | None | $60.26 | $69.18 | $104.71 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $194.98 | Professional | None | $72.44 | $138.04 | $194.98 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $85.11 Typical High $97.72 | Facility | None | $64.57 | $85.11 | $97.72 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $104.71 | Professional | None | $61.66 | $72.44 | $104.71 |
United Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $208.93 | Facility | None | $154.88 | $158.49 | $208.93 |
United Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $112.20 | Professional | None | $60.26 | $79.43 | $112.20 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.11 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $33.11 | $37.15 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $54.95 Median $72.44 Typical High $85.11 | Professional | 25 · Same-day visit | $54.95 | $72.44 | $85.11 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $64.57 Median $83.18 Typical High $85.11 | Professional | 33 · Preventive service | $64.57 | $83.18 | $85.11 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | Q6 · Substitute physician, paid per time | $89.13 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | SA · Nurse practitioner | $85.11 | $85.11 | $112.20 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $63.10 Median $79.43 Typical High $190.55 | Professional | 25 · Same-day visit | $63.10 | $79.43 | $190.55 |
Moda Health Setting Professional Modifier 33 · Preventive service Typical Low $66.07 Median $81.28 Typical High $144.54 | Professional | 33 · Preventive service | $66.07 | $81.28 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.11 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $33.11 | $34.67 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | G0 · Stroke telehealth | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | GQ · Store-and-forward telehealth | $173.78 | $173.78 | $173.78 |
Where Texas sits
The same service costs 2.8 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· 42nd of 51
$72.44
AK $182NY $64.57
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.