How much rates vary
Facilitymedian $437 · 10th to 90th $282 to $437Professionalmedian $427 · 10th to 90th $85 to $1,349
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $562.34 | Professional | None | $316.23 | $436.52 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | None | $263.03 | $263.03 | $302.00 |
BCBS Texas Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | None | $346.74 | $398.11 | $398.11 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,168.69 Typical High $4,168.69 | Professional | None | $2,691.53 | $4,168.69 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $645.65 | Professional | None | $323.59 | $436.52 | $645.65 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $407.38 Typical High $549.54 | Professional | None | $74.13 | $407.38 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $269.15 Median $281.84 Typical High $371.54 | Facility | None | $269.15 | $281.84 | $371.54 |
United Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $537.03 | Professional | None | $239.88 | $346.74 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $204.17 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $81.28 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $87.10 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $43.65 |
United Setting Professional Modifier G0 · Stroke telehealth Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | G0 · Stroke telehealth | $758.58 | $758.58 | $758.58 |
United Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | GQ · Store-and-forward telehealth | $758.58 | $758.58 | $758.58 |
Where Texas sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 20th of 51
$427
WY $661MD $309
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.