How much rates vary
Facilitymedian $35 · 10th to 90th $19 to $115Professionalmedian $11 · 10th to 90th $5 to $20
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 $12.30 Median $24.55 Typical High $95.50 | Facility | None | $12.30 | $24.55 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $23.99 | Professional | None | $11.22 | $11.75 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $9.33 Typical High $11.48 | Professional | None | $9.12 | $9.33 | $11.48 |
BCBS Texas Setting Facility Modifier None Typical Low $22.91 Median $66.07 Typical High $125.89 | Facility | None | $22.91 | $66.07 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $10.23 Typical High $18.62 | Professional | None | $5.01 | $10.23 | $18.62 |
Christus Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $40.74 Typical High $77.62 | Facility | None | $19.05 | $40.74 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $31.62 | Professional | None | $10.72 | $13.49 | $31.62 |
Health Smart Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Health Smart Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | None | $28.18 | $28.18 | $28.84 |
Lucent Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $34.67 Typical High $144.54 | Facility | None | $14.13 | $34.67 | $144.54 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $22.39 | Professional | None | $11.22 | $14.13 | $22.39 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | None | $14.13 | $15.85 | $15.85 |
Providence Setting Facility Modifier None Typical Low $15.14 Median $27.54 Typical High $77.62 | Facility | None | $15.14 | $27.54 | $77.62 |
Providence Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $28.18 | Professional | None | $10.72 | $13.49 | $28.18 |
United Setting Facility Modifier None Typical Low $6.76 Median $7.94 Typical High $18.62 | Facility | None | $6.76 | $7.94 | $18.62 |
United Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $15.85 | Professional | None | $7.94 | $10.72 | $15.85 |
Wellpoint Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | None | $9.33 | $9.33 | $9.77 |
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 $6.31 Median $13.49 Typical High $51.29 | Facility | 52 · Reduced service | $6.31 | $13.49 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.51 Median $5.37 Typical High $20.42 | Facility | 53 · Discontinued | $2.51 | $5.37 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $6.17 Typical High $11.22 | Professional | 52 · Reduced service | $5.62 | $6.17 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.45 Typical High $4.47 | Professional | 53 · Discontinued | $2.24 | $2.45 | $4.47 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $7.08 Median $13.49 Typical High $51.29 | Facility | 52 · Reduced service | $7.08 | $13.49 | $51.29 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.82 Median $5.37 Typical High $20.42 | Facility | 53 · Discontinued | $2.82 | $5.37 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.89 Typical High $9.12 | Professional | 52 · Reduced service | $5.62 | $5.89 | $9.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.34 Typical High $3.63 | Professional | 53 · Discontinued | $2.24 | $2.34 | $3.63 |
Where Texas sits
The same service costs 10.0 times more in Vermont 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· 26th of 51
$18.62
VT $141MD $14.13
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.