How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $13Professionalmedian $2 · 10th to 90th $1 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 $1.45 Median $3.09 Typical High $11.75 | Facility | None | $1.45 | $3.09 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.45 Typical High $3.24 | Professional | None | $1.29 | $1.45 | $3.24 |
Ambetter Setting Professional Modifier None Typical Low $1.10 Median $1.32 Typical High $1.91 | Professional | None | $1.10 | $1.32 | $1.91 |
BCBS Texas Setting Facility Modifier None Typical Low $2.63 Median $7.59 Typical High $14.45 | Facility | None | $2.63 | $7.59 | $14.45 |
BCBS Texas Setting Professional Modifier None Typical Low $1.20 Median $2.40 Typical High $5.50 | Professional | None | $1.20 | $2.40 | $5.50 |
Christus Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $4.68 Typical High $9.12 | Facility | None | $2.19 | $4.68 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.55 Typical High $3.63 | Professional | None | $1.29 | $1.55 | $3.63 |
Health Smart Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Health Smart Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.31 | Professional | None | $3.02 | $3.02 | $3.31 |
Lucent Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Moda Health Setting Facility Modifier None Typical Low $1.62 Median $2.29 Typical High $5.89 | Facility | None | $1.62 | $2.29 | $5.89 |
Moda Health Setting Professional Modifier None Typical Low $1.29 Median $1.55 Typical High $3.24 | Professional | None | $1.29 | $1.55 | $3.24 |
Molina Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $1.82 | Professional | None | $1.62 | $1.82 | $1.82 |
Providence Setting Facility Modifier None Typical Low $1.74 Median $3.16 Typical High $9.12 | Facility | None | $1.74 | $3.16 | $9.12 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.55 Typical High $3.24 | Professional | None | $1.29 | $1.55 | $3.24 |
United Setting Facility Modifier None Typical Low $0.78 Median $2.19 Typical High $6.03 | Facility | None | $0.78 | $2.19 | $6.03 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.78 Typical High $2.19 | Professional | None | $1.29 | $1.78 | $2.19 |
Wellpoint Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.12 | Professional | None | $1.07 | $1.07 | $1.12 |
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 $0.72 Median $1.55 Typical High $5.89 | Facility | 52 · Reduced service | $0.72 | $1.55 | $5.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.28 Median $0.62 Typical High $2.34 | Facility | 53 · Discontinued | $0.28 | $0.62 | $2.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.72 Typical High $1.29 | Professional | 52 · Reduced service | $0.65 | $0.72 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.28 Typical High $0.52 | Professional | 53 · Discontinued | $0.26 | $0.28 | $0.52 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $0.81 Median $1.55 Typical High $5.89 | Facility | 52 · Reduced service | $0.81 | $1.55 | $5.89 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.33 Median $0.62 Typical High $2.34 | Facility | 53 · Discontinued | $0.33 | $0.62 | $2.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.68 Typical High $1.05 | Professional | 52 · Reduced service | $0.65 | $0.68 | $1.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.27 Typical High $0.42 | Professional | 53 · Discontinued | $0.26 | $0.27 | $0.42 |
Where Texas sits
The same service costs 3.2 times more in Kansas 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· 11th of 51
$3.02
KS $5.62DC $1.74
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.