How much rates vary
Facilitymedian $9 · 10th to 90th $4 to $66Professionalmedian $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 $2.57 Median $5.13 Typical High $19.95 | Facility | None | $2.57 | $5.13 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $5.37 | Professional | None | $2.34 | $2.57 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $2.40 | Professional | None | $1.91 | $1.95 | $2.40 |
BCBS Texas Setting Facility Modifier None Typical Low $5.37 Median $14.13 Typical High $26.30 | Facility | None | $5.37 | $14.13 | $26.30 |
BCBS Texas Setting Professional Modifier None Typical Low $2.14 Median $3.89 Typical High $5.50 | Professional | None | $2.14 | $3.89 | $5.50 |
Christus Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $8.51 Typical High $16.22 | Facility | None | $3.98 | $8.51 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.75 Typical High $6.46 | Professional | None | $2.19 | $2.75 | $6.46 |
Health Smart Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Health Smart Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | None | $5.89 | $5.89 | $6.03 |
Lucent Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $60.26 Typical High $93.33 | Facility | None | $3.55 | $60.26 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $6.03 | Professional | None | $2.34 | $2.95 | $6.03 |
Molina Setting Professional Modifier None Typical Low $2.95 Median $3.31 Typical High $3.31 | Professional | None | $2.95 | $3.31 | $3.31 |
Providence Setting Facility Modifier None Typical Low $3.16 Median $5.75 Typical High $16.22 | Facility | None | $3.16 | $5.75 | $16.22 |
Providence Setting Professional Modifier None Typical Low $2.19 Median $2.75 Typical High $5.89 | Professional | None | $2.19 | $2.75 | $5.89 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.66 Typical High $3.89 | Facility | None | $1.41 | $1.66 | $3.89 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $4.17 | Professional | None | $2.34 | $3.24 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | None | $1.95 | $1.95 | $2.04 |
9 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 $1.32 Median $2.82 Typical High $10.72 | Facility | 52 · Reduced service | $1.32 | $2.82 | $10.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.52 Median $1.12 Typical High $4.27 | Facility | 53 · Discontinued | $0.52 | $1.12 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.29 Typical High $2.34 | Professional | 52 · Reduced service | $1.17 | $1.29 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.52 Typical High $0.93 | Professional | 53 · Discontinued | $0.47 | $0.52 | $0.93 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.48 Median $2.82 Typical High $10.72 | Facility | 52 · Reduced service | $1.48 | $2.82 | $10.72 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.60 Median $1.12 Typical High $4.27 | Facility | 53 · Discontinued | $0.60 | $1.12 | $4.27 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $13.18 Median $17.38 Typical High $18.20 | Facility | 59 · Distinct service | $13.18 | $17.38 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.23 Typical High $1.91 | Professional | 52 · Reduced service | $1.17 | $1.23 | $1.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.49 Typical High $0.76 | Professional | 53 · Discontinued | $0.47 | $0.49 | $0.76 |
Where Texas sits
The same service costs 5.8 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
$5.01
MN $18.20DC $3.16
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.