How much rates vary
Facilitymedian $51 · 10th to 90th $16 to $93Professionalmedian $15 · 10th to 90th $12 to $170
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 $8.91 Median $8.91 Typical High $15.49 | Facility | None | $8.91 | $8.91 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $12.88 Typical High $15.49 | Professional | None | $8.91 | $12.88 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | None | $13.49 | $15.49 | $15.49 |
BCBS Texas Setting Facility Modifier None Typical Low $19.95 Median $46.77 Typical High $83.18 | Facility | None | $19.95 | $46.77 | $83.18 |
BCBS Texas Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $54.95 | Professional | None | $13.18 | $13.18 | $54.95 |
Christus Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Lucent Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | None | $134.90 | $134.90 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $13.49 Median $17.78 Typical High $125.89 | Facility | None | $13.49 | $17.78 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $8.91 Median $12.88 Typical High $15.49 | Professional | None | $8.91 | $12.88 | $15.49 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Oscar Health Setting Professional Modifier None Typical Low $15.85 Median $29.51 Typical High $36.31 | Professional | None | $15.85 | $29.51 | $36.31 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $16.22 Typical High $22.91 | Facility | None | $14.79 | $16.22 | $22.91 |
Providence Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $17.78 | Facility | None | $12.88 | $12.88 | $17.78 |
United Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $22.39 | Professional | None | $11.75 | $14.79 | $22.39 |
Wellpoint Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
9 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 $4.47 Median $5.75 Typical High $7.76 | Professional | 52 · Reduced service | $4.47 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $2.29 Typical High $3.09 | Professional | 53 · Discontinued | $1.82 | $2.29 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.74 Typical High $2.29 | Professional | 55 · Aftercare only | $1.35 | $1.74 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.15 Typical High $1.55 | Professional | 56 · Pre-op care only | $0.89 | $1.15 | $1.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.47 Median $5.75 Typical High $7.59 | Professional | 52 · Reduced service | $4.47 | $5.75 | $7.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $2.34 Typical High $3.02 | Professional | 53 · Discontinued | $1.82 | $2.34 | $3.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.74 Typical High $2.29 | Professional | 55 · Aftercare only | $1.35 | $1.74 | $2.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.15 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.89 | $1.15 | $1.51 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | G0 · Stroke telehealth | $26.92 | $26.92 | $26.92 |
Where Texas sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 48th of 51
$14.79
AK $38.90LA $13.80
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.