How much rates vary
Facilitymedian $20 · 10th to 90th $9 to $91Professionalmedian $5 · 10th to 90th $5 to $10
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 $5.75 Median $11.22 Typical High $47.86 | Facility | None | $5.75 | $11.22 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $12.59 | Professional | None | $5.62 | $6.17 | $12.59 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $5.75 Typical High $9.33 | Professional | None | $4.47 | $5.75 | $9.33 |
BCBS Texas Setting Facility Modifier None Typical Low $10.23 Median $30.90 Typical High $61.66 | Facility | None | $10.23 | $30.90 | $61.66 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $9.33 | Professional | None | $5.01 | $5.25 | $9.33 |
Baylor Scott & White Setting Facility Modifier None Typical Low $8.51 Median $12.59 Typical High $478.63 | Facility | None | $8.51 | $12.59 | $478.63 |
Christus Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $20.42 Typical High $38.02 | Facility | None | $9.33 | $20.42 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $15.85 | Professional | None | $5.37 | $6.92 | $15.85 |
Health Smart Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Health Smart Setting Professional Modifier None Typical Low $8.32 Median $13.80 Typical High $15.49 | Professional | None | $8.32 | $13.80 | $15.49 |
Lucent Health Setting Professional Modifier None Typical Low $8.32 Median $8.91 Typical High $15.49 | Professional | None | $8.32 | $8.91 | $15.49 |
Moda Health Setting Facility Modifier None Typical Low $8.32 Median $52.48 Typical High $213.80 | Facility | None | $8.32 | $52.48 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $11.22 | Professional | None | $5.62 | $7.94 | $11.22 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $7.76 Typical High $7.76 | Professional | None | $6.92 | $7.76 | $7.76 |
Providence Setting Facility Modifier None Typical Low $7.41 Median $13.80 Typical High $38.02 | Facility | None | $7.41 | $13.80 | $38.02 |
Providence Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $14.13 | Professional | None | $5.37 | $6.76 | $14.13 |
United Setting Facility Modifier None Typical Low $3.39 Median $9.33 Typical High $12.02 | Facility | None | $3.39 | $9.33 | $12.02 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $7.59 | Professional | None | $3.89 | $5.37 | $7.59 |
Wellpoint Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.79 | Professional | None | $4.57 | $4.57 | $4.79 |
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 $3.09 Median $6.76 Typical High $25.12 | Facility | 52 · Reduced service | $3.09 | $6.76 | $25.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.26 Median $2.69 Typical High $10.00 | Facility | 53 · Discontinued | $1.26 | $2.69 | $10.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $3.09 Typical High $5.62 | Professional | 52 · Reduced service | $2.82 | $3.09 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.23 Typical High $2.24 | Professional | 53 · Discontinued | $1.12 | $1.23 | $2.24 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.55 Median $6.76 Typical High $25.12 | Facility | 52 · Reduced service | $3.55 | $6.76 | $25.12 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.41 Median $2.69 Typical High $10.00 | Facility | 53 · Discontinued | $1.41 | $2.69 | $10.00 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $30.90 Median $56.23 Typical High $162.18 | Facility | 59 · Distinct service | $30.90 | $56.23 | $162.18 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $77.62 Median $89.13 Typical High $93.33 | Facility | XU · Unusual separate service | $77.62 | $89.13 | $93.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $2.88 Typical High $4.47 | Professional | 52 · Reduced service | $2.82 | $2.88 | $4.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.15 Typical High $1.82 | Professional | 53 · Discontinued | $1.12 | $1.15 | $1.82 |
Where Texas sits
The same service costs 12.9 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· 14th of 51
$12.88
VT $89.13MD $6.92
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.