How much rates vary
Facilitymedian $21 · 10th to 90th $8 to $275Professionalmedian $5 · 10th to 90th $4 to $9
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 $5.13 Median $8.51 Typical High $41.69 | Facility | None | $5.13 | $8.51 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $11.22 | Professional | None | $4.90 | $5.89 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $4.07 Typical High $8.13 | Professional | None | $2.88 | $4.07 | $8.13 |
BCBS Texas Setting Facility Modifier None Typical Low $8.91 Median $26.30 Typical High $54.95 | Facility | None | $8.91 | $26.30 | $54.95 |
BCBS Texas Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $6.61 | Professional | None | $4.47 | $5.01 | $6.61 |
Baylor Scott & White Setting Facility Modifier None Typical Low $7.59 Median $8.13 Typical High $77.62 | Facility | None | $7.59 | $8.13 | $77.62 |
Christus Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $17.78 Typical High $33.88 | Facility | None | $8.13 | $17.78 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $13.80 | Professional | None | $4.57 | $6.03 | $13.80 |
Health Smart Setting Facility Modifier None Typical Low $12.59 Median $15.14 Typical High $15.14 | Facility | None | $12.59 | $15.14 | $15.14 |
Health Smart Setting Professional Modifier None Typical Low $6.92 Median $10.23 Typical High $15.14 | Professional | None | $6.92 | $10.23 | $15.14 |
Lucent Health Setting Professional Modifier None Typical Low $6.92 Median $10.23 Typical High $30.20 | Professional | None | $6.92 | $10.23 | $30.20 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $154.88 Typical High $389.05 | Facility | None | $8.13 | $154.88 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $6.46 Typical High $11.22 | Professional | None | $4.90 | $6.46 | $11.22 |
Molina Setting Professional Modifier None Typical Low $6.17 Median $6.92 Typical High $6.92 | Professional | None | $6.17 | $6.92 | $6.92 |
Providence Setting Facility Modifier None Typical Low $6.61 Median $12.02 Typical High $33.88 | Facility | None | $6.61 | $12.02 | $33.88 |
Providence Setting Professional Modifier None Typical Low $4.57 Median $5.89 Typical High $12.30 | Professional | None | $4.57 | $5.89 | $12.30 |
United Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $8.13 | Facility | None | $2.75 | $2.75 | $8.13 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.68 Typical High $6.61 | Professional | None | $3.47 | $4.68 | $6.61 |
Wellpoint Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | None | $4.07 | $4.07 | $4.27 |
8 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 Facility Modifier 52 · Reduced service Typical Low $2.75 Median $5.89 Typical High $21.88 | Facility | 52 · Reduced service | $2.75 | $5.89 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.10 Median $2.34 Typical High $8.91 | Facility | 53 · Discontinued | $1.10 | $2.34 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.69 Typical High $4.90 | Professional | 52 · Reduced service | $2.45 | $2.69 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.07 Typical High $1.95 | Professional | 53 · Discontinued | $0.98 | $1.07 | $1.95 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.09 Median $5.89 Typical High $21.88 | Facility | 52 · Reduced service | $3.09 | $5.89 | $21.88 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.23 Median $2.34 Typical High $8.91 | Facility | 53 · Discontinued | $1.23 | $2.34 | $8.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.51 Typical High $3.98 | Professional | 52 · Reduced service | $2.45 | $2.51 | $3.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.00 Typical High $1.58 | Professional | 53 · Discontinued | $0.98 | $1.00 | $1.58 |
Where Texas sits
The same service costs 17.0 times more in Vermont than in Kentucky. 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· 31st of 51
$8.13
VT $100KY $5.89
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.