How much rates vary
Facilitymedian $14 · 10th to 90th $6 to $91Professionalmedian $5 · 10th to 90th $3 to $7
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 $3.72 Median $7.24 Typical High $30.90 | Facility | None | $3.72 | $7.24 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.07 Typical High $8.13 | Professional | None | $3.63 | $4.07 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $2.09 Median $3.02 Typical High $6.03 | Professional | None | $2.09 | $3.02 | $6.03 |
BCBS Texas Setting Facility Modifier None Typical Low $6.61 Median $19.50 Typical High $39.81 | Facility | None | $6.61 | $19.50 | $39.81 |
BCBS Texas Setting Professional Modifier None Typical Low $3.31 Median $5.01 Typical High $6.03 | Professional | None | $3.31 | $5.01 | $6.03 |
Baylor Scott & White Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $8.13 | Facility | None | $6.03 | $6.03 | $8.13 |
Christus Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $13.18 Typical High $25.12 | Facility | None | $6.03 | $13.18 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $4.90 Typical High $10.72 | Professional | None | $3.47 | $4.90 | $10.72 |
Health Smart Setting Facility Modifier None Typical Low $9.33 Median $10.96 Typical High $10.96 | Facility | None | $9.33 | $10.96 | $10.96 |
Health Smart Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $11.22 | Professional | None | $5.50 | $7.76 | $11.22 |
Lucent Health Setting Professional Modifier None Typical Low $5.25 Median $7.76 Typical High $12.30 | Professional | None | $5.25 | $7.76 | $12.30 |
Moda Health Setting Facility Modifier None Typical Low $5.89 Median $63.10 Typical High $229.09 | Facility | None | $5.89 | $63.10 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $7.08 | Professional | None | $3.24 | $4.90 | $7.08 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $5.13 Typical High $5.13 | Professional | None | $4.57 | $5.13 | $5.13 |
Providence Setting Facility Modifier None Typical Low $4.79 Median $8.91 Typical High $25.12 | Facility | None | $4.79 | $8.91 | $25.12 |
Providence Setting Professional Modifier None Typical Low $3.47 Median $4.90 Typical High $10.47 | Professional | None | $3.47 | $4.90 | $10.47 |
United Setting Facility Modifier None Typical Low $2.19 Median $6.03 Typical High $15.14 | Facility | None | $2.19 | $6.03 | $15.14 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $4.90 | Professional | None | $2.51 | $3.47 | $4.90 |
Wellpoint Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.16 | Professional | None | $2.95 | $2.95 | $3.16 |
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 $2.04 Median $4.37 Typical High $16.22 | Facility | 52 · Reduced service | $2.04 | $4.37 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.81 Median $1.74 Typical High $6.61 | Facility | 53 · Discontinued | $0.81 | $1.74 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $2.00 Typical High $3.63 | Professional | 52 · Reduced service | $1.82 | $2.00 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.79 Typical High $1.45 | Professional | 53 · Discontinued | $0.72 | $0.79 | $1.45 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.29 Median $4.37 Typical High $16.22 | Facility | 52 · Reduced service | $2.29 | $4.37 | $16.22 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.91 Median $1.74 Typical High $6.61 | Facility | 53 · Discontinued | $0.91 | $1.74 | $6.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $1.86 Typical High $2.95 | Professional | 52 · Reduced service | $1.82 | $1.86 | $2.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.76 Typical High $1.17 | Professional | 53 · Discontinued | $0.72 | $0.76 | $1.17 |
Where Texas sits
The same service costs 6.2 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· 30th of 51
$6.17
VT $28.18MD $4.57
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.