How much rates vary
Facilitymedian $11 · 10th to 90th $5 to $48Professionalmedian $4 · 10th to 90th $3 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 $3.24 Median $6.31 Typical High $25.12 | Facility | None | $3.24 | $6.31 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.47 Typical High $6.76 | Professional | None | $2.95 | $3.47 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $2.40 Median $3.31 Typical High $4.90 | Professional | None | $2.40 | $3.31 | $4.90 |
BCBS Texas Setting Facility Modifier None Typical Low $5.50 Median $16.60 Typical High $32.36 | Facility | None | $5.50 | $16.60 | $32.36 |
BCBS Texas Setting Professional Modifier None Typical Low $2.69 Median $4.90 Typical High $5.50 | Professional | None | $2.69 | $4.90 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $35.48 | Facility | None | $4.90 | $4.90 | $35.48 |
Christus Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $10.72 Typical High $19.95 | Facility | None | $5.01 | $10.72 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $2.75 Median $3.80 Typical High $8.13 | Professional | None | $2.75 | $3.80 | $8.13 |
Health Smart Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Health Smart Setting Professional Modifier None Typical Low $4.37 Median $4.57 Typical High $7.59 | Professional | None | $4.37 | $4.57 | $7.59 |
Lucent Health Setting Professional Modifier None Typical Low $4.37 Median $4.57 Typical High $8.13 | Professional | None | $4.37 | $4.57 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $4.79 Median $31.62 Typical High $100.00 | Facility | None | $4.79 | $31.62 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $6.92 | Professional | None | $2.95 | $4.37 | $6.92 |
Molina Setting Professional Modifier None Typical Low $3.72 Median $4.17 Typical High $4.17 | Professional | None | $3.72 | $4.17 | $4.17 |
Providence Setting Facility Modifier None Typical Low $3.98 Median $7.24 Typical High $19.95 | Facility | None | $3.98 | $7.24 | $19.95 |
Providence Setting Professional Modifier None Typical Low $2.75 Median $3.63 Typical High $7.41 | Professional | None | $2.75 | $3.63 | $7.41 |
United Setting Facility Modifier None Typical Low $1.38 Median $2.09 Typical High $10.47 | Facility | None | $1.38 | $2.09 | $10.47 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.82 Typical High $4.07 | Professional | None | $2.09 | $2.82 | $4.07 |
Wellpoint Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
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 $1.66 Median $3.55 Typical High $13.49 | Facility | 52 · Reduced service | $1.66 | $3.55 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.66 Median $1.45 Typical High $5.37 | Facility | 53 · Discontinued | $0.66 | $1.45 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.62 Typical High $2.95 | Professional | 52 · Reduced service | $1.48 | $1.62 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.65 Typical High $1.20 | Professional | 53 · Discontinued | $0.59 | $0.65 | $1.20 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.86 Median $3.55 Typical High $13.49 | Facility | 52 · Reduced service | $1.86 | $3.55 | $13.49 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.76 Median $1.45 Typical High $5.37 | Facility | 53 · Discontinued | $0.76 | $1.45 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.55 Typical High $2.40 | Professional | 52 · Reduced service | $1.48 | $1.55 | $2.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.62 Typical High $0.95 | Professional | 53 · Discontinued | $0.59 | $0.62 | $0.95 |
Where Texas sits
The same service costs 9.3 times more in Vermont than in Georgia. 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· 24th of 51
$5.50
VT $33.88GA $3.63
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.