How much rates vary
Facilitymedian $27 · 10th to 90th $8 to $27Professionalmedian $15 · 10th to 90th $8 to $115
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 $5.25 Median $9.33 Typical High $15.14 | Facility | None | $5.25 | $9.33 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $10.47 Typical High $19.05 | Professional | None | $5.75 | $10.47 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $15.85 Typical High $18.20 | Professional | None | $7.94 | $15.85 | $18.20 |
BCBS Texas Setting Facility Modifier None Typical Low $74.13 Median $204.17 Typical High $204.17 | Facility | None | $74.13 | $204.17 | $204.17 |
BCBS Texas Setting Professional Modifier None Typical Low $7.59 Median $14.79 Typical High $19.95 | Professional | None | $7.59 | $14.79 | $19.95 |
Baylor Scott & White Setting Professional Modifier None Typical Low $15.85 Median $18.62 Typical High $25.12 | Professional | None | $15.85 | $18.62 | $25.12 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Health Smart Setting Professional Modifier None Typical Low $17.38 Median $20.89 Typical High $23.99 | Professional | None | $17.38 | $20.89 | $23.99 |
Lucent Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $158.49 | Professional | None | $114.82 | $114.82 | $158.49 |
Moda Health Setting Facility Modifier None Typical Low $7.94 Median $15.14 Typical High $41.69 | Facility | None | $7.94 | $15.14 | $41.69 |
Moda Health Setting Professional Modifier None Typical Low $5.75 Median $10.47 Typical High $19.05 | Professional | None | $5.75 | $10.47 | $19.05 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $416.87 | Professional | None | $165.96 | $165.96 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $8.51 Median $19.05 Typical High $40.74 | Professional | None | $8.51 | $19.05 | $40.74 |
Providence Setting Facility Modifier None Typical Low $7.94 Median $12.02 Typical High $20.42 | Facility | None | $7.94 | $12.02 | $20.42 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 $7.76 Median $13.80 Typical High $22.39 | Professional | None | $7.76 | $13.80 | $22.39 |
Wellpoint Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
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 $2.63 Median $5.25 Typical High $8.51 | Professional | 52 · Reduced service | $2.63 | $5.25 | $8.51 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $15.49 Median $18.20 Typical High $19.05 | Professional | 59 · Distinct service | $15.49 | $18.20 | $19.05 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | Q6 · Substitute physician, paid per time | $18.20 | $18.20 | $18.20 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $17.38 Median $18.20 Typical High $18.62 | Professional | XU · Unusual separate service | $17.38 | $18.20 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $5.25 Typical High $7.76 | Professional | 52 · Reduced service | $2.63 | $5.25 | $7.76 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $15.14 Median $19.95 Typical High $36.31 | Professional | 59 · Distinct service | $15.14 | $19.95 | $36.31 |
Moda Health Setting Professional Modifier XU · Unusual separate service Typical Low $12.59 Median $19.95 Typical High $25.12 | Professional | XU · Unusual separate service | $12.59 | $19.95 | $25.12 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | G0 · Stroke telehealth | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | GQ · Store-and-forward telehealth | $33.88 | $33.88 | $33.88 |
Where Texas sits
The same service costs 2.3 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· 46th of 51
$14.79
AK $30.90LA $13.49
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.