How much rates vary
Facilitymedian $37 · 10th to 90th $27 to $129Professionalmedian $30 · 10th to 90th $23 to $200
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 $20.89 Median $24.55 Typical High $35.48 | Facility | None | $20.89 | $24.55 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $30.20 Typical High $40.74 | Professional | None | $21.88 | $30.20 | $40.74 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | None | $30.90 | $30.90 | $31.62 |
BCBS Texas Setting Facility Modifier None Typical Low $38.90 Median $87.10 Typical High $158.49 | Facility | None | $38.90 | $87.10 | $158.49 |
BCBS Texas Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $41.69 | Professional | None | $22.91 | $26.92 | $41.69 |
Christus Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $269.15 | Professional | None | $199.53 | $269.15 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $29.51 Typical High $35.48 | Facility | None | $21.88 | $29.51 | $35.48 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $30.20 Typical High $40.74 | Professional | None | $22.91 | $30.20 | $40.74 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Oscar Health Setting Professional Modifier None Typical Low $22.91 Median $45.71 Typical High $75.86 | Professional | None | $22.91 | $45.71 | $75.86 |
Providence Setting Facility Modifier None Typical Low $21.88 Median $30.90 Typical High $42.66 | Facility | None | $21.88 | $30.90 | $42.66 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $23.99 | Facility | None | $17.78 | $17.78 | $23.99 |
United Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $41.69 | Professional | None | $21.88 | $28.18 | $41.69 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 $10.47 Median $15.14 Typical High $19.95 | Professional | 52 · Reduced service | $10.47 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $6.03 Typical High $8.13 | Professional | 53 · Discontinued | $4.27 | $6.03 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.57 Typical High $6.03 | Professional | 55 · Aftercare only | $3.16 | $4.57 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.02 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.09 | $3.02 | $4.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $15.14 Typical High $19.05 | Professional | 52 · Reduced service | $10.47 | $15.14 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $6.03 Typical High $7.59 | Professional | 53 · Discontinued | $4.27 | $6.03 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $4.57 Typical High $5.62 | Professional | 55 · Aftercare only | $3.16 | $4.57 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.02 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.09 | $3.02 | $3.80 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | G0 · Stroke telehealth | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | GQ · Store-and-forward telehealth | $56.23 | $56.23 | $56.23 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 39th of 51
$29.51
AK $74.13IN $19.50
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.