How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $58Professionalmedian $6 · 10th to 90th $5 to $11
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 $6.61 Median $13.18 Typical High $53.70 | Facility | None | $6.61 | $13.18 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.92 Typical High $14.13 | Professional | None | $6.31 | $6.92 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $10.47 | Professional | None | $5.01 | $5.25 | $10.47 |
BCBS Texas Setting Facility Modifier None Typical Low $11.75 Median $33.88 Typical High $69.18 | Facility | None | $11.75 | $33.88 | $69.18 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $5.75 Typical High $6.92 | Professional | None | $5.01 | $5.75 | $6.92 |
Christus Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $22.91 Typical High $39.81 | Facility | None | $10.23 | $22.91 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $9.33 Typical High $18.62 | Professional | None | $5.62 | $9.33 | $18.62 |
Health Smart Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Health Smart Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $15.49 | Professional | None | $9.33 | $9.77 | $15.49 |
Lucent Health Setting Professional Modifier None Typical Low $14.13 Median $15.14 Typical High $19.50 | Professional | None | $14.13 | $15.14 | $19.50 |
Moda Health Setting Facility Modifier None Typical Low $7.94 Median $12.02 Typical High $57.54 | Facility | None | $7.94 | $12.02 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $6.31 Median $7.94 Typical High $12.59 | Professional | None | $6.31 | $7.94 | $12.59 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $8.91 Typical High $8.91 | Professional | None | $7.94 | $8.91 | $8.91 |
Providence Setting Facility Modifier None Typical Low $7.94 Median $14.13 Typical High $38.90 | Facility | None | $7.94 | $14.13 | $38.90 |
Providence Setting Professional Modifier None Typical Low $5.62 Median $8.51 Typical High $17.78 | Professional | None | $5.62 | $8.51 | $17.78 |
United Setting Facility Modifier None Typical Low $3.80 Median $4.37 Typical High $10.47 | Facility | None | $3.80 | $4.37 | $10.47 |
United Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $8.13 | Professional | None | $4.37 | $5.50 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
11 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 $3.55 Median $7.59 Typical High $28.18 | Facility | 52 · Reduced service | $3.55 | $7.59 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.41 Median $3.02 Typical High $11.48 | Facility | 53 · Discontinued | $1.41 | $3.02 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.16 Median $3.47 Typical High $6.31 | Professional | 52 · Reduced service | $3.16 | $3.47 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.38 Typical High $2.51 | Professional | 53 · Discontinued | $1.26 | $1.38 | $2.51 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.98 Median $7.59 Typical High $28.18 | Facility | 52 · Reduced service | $3.98 | $7.59 | $28.18 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.58 Median $3.02 Typical High $11.48 | Facility | 53 · Discontinued | $1.58 | $3.02 | $11.48 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $30.90 Median $40.74 Typical High $1,737.80 | Facility | 59 · Distinct service | $30.90 | $40.74 | $1,737.80 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $31.62 Median $64.57 Typical High $87.10 | Facility | XU · Unusual separate service | $31.62 | $64.57 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.16 Median $3.24 Typical High $5.13 | Professional | 52 · Reduced service | $3.16 | $3.24 | $5.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.29 Typical High $2.04 | Professional | 53 · Discontinued | $1.26 | $1.29 | $2.04 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $7.08 Median $8.71 Typical High $10.47 | Professional | 59 · Distinct service | $7.08 | $8.71 | $10.47 |
Where Texas sits
The same service costs 5.6 times more in Minnesota than in New Jersey. 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· 27th of 51
$10.47
MN $41.69NJ $7.41
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.