How much rates vary
Facilitymedian $9 · 10th to 90th $2 to $115Professionalmedian $3 · 10th to 90th $2 to $5
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 $1.95 Median $2.51 Typical High $16.22 | Facility | None | $1.95 | $2.51 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $4.57 | Professional | None | $1.91 | $2.14 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $1.32 Median $1.58 Typical High $2.69 | Professional | None | $1.32 | $1.58 | $2.69 |
BCBS Texas Setting Facility Modifier None Typical Low $2.04 Median $7.59 Typical High $19.95 | Facility | None | $2.04 | $7.59 | $19.95 |
BCBS Texas Setting Professional Modifier None Typical Low $2.04 Median $5.01 Typical High $5.50 | Professional | None | $2.04 | $5.01 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $97.72 | Facility | None | $2.24 | $2.24 | $97.72 |
Christus Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $6.92 Typical High $13.18 | Facility | None | $3.16 | $6.92 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $3.47 Typical High $5.50 | Professional | None | $2.04 | $3.47 | $5.50 |
Health Smart Setting Facility Modifier None Typical Low $4.90 Median $6.03 Typical High $18.20 | Facility | None | $4.90 | $6.03 | $18.20 |
Health Smart Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $6.03 | Professional | None | $2.75 | $4.17 | $6.03 |
Lucent Health Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $6.03 | Professional | None | $2.75 | $4.17 | $6.03 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $67.61 Typical High $239.88 | Facility | None | $3.24 | $67.61 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $1.91 Median $2.75 Typical High $4.79 | Professional | None | $1.91 | $2.75 | $4.79 |
Molina Setting Professional Modifier None Typical Low $2.40 Median $2.63 Typical High $2.63 | Professional | None | $2.40 | $2.63 | $2.63 |
Providence Setting Facility Modifier None Typical Low $2.51 Median $4.68 Typical High $13.18 | Facility | None | $2.51 | $4.68 | $13.18 |
Providence Setting Professional Modifier None Typical Low $2.04 Median $3.16 Typical High $5.50 | Professional | None | $2.04 | $3.16 | $5.50 |
United Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $3.16 | Facility | None | $1.12 | $1.12 | $3.16 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.57 Typical High $3.16 | Professional | None | $1.91 | $2.57 | $3.16 |
Wellpoint Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.62 | Professional | None | $1.58 | $1.58 | $1.62 |
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 Facility Modifier 52 · Reduced service Typical Low $1.07 Median $2.29 Typical High $8.51 | Facility | 52 · Reduced service | $1.07 | $2.29 | $8.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.42 Median $0.91 Typical High $3.47 | Facility | 53 · Discontinued | $0.42 | $0.91 | $3.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $1.05 Typical High $1.91 | Professional | 52 · Reduced service | $0.95 | $1.05 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.42 Typical High $0.76 | Professional | 53 · Discontinued | $0.38 | $0.42 | $0.76 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.20 Median $2.29 Typical High $8.51 | Facility | 52 · Reduced service | $1.20 | $2.29 | $8.51 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.48 Median $0.91 Typical High $3.47 | Facility | 53 · Discontinued | $0.48 | $0.91 | $3.47 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $13.49 Median $95.50 Typical High $1,000.00 | Facility | 59 · Distinct service | $13.49 | $95.50 | $1,000.00 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $48.98 Median $70.79 Typical High $616.60 | Facility | XU · Unusual separate service | $48.98 | $70.79 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $1.00 Typical High $1.55 | Professional | 52 · Reduced service | $0.95 | $1.00 | $1.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.39 Typical High $0.62 | Professional | 53 · Discontinued | $0.38 | $0.39 | $0.62 |
Where Texas sits
The same service costs 22.4 times more in Minnesota than in Washington, DC. 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· 16th of 51
$4.27
MN $56.23DC $2.51
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.