How much rates vary
Facilitymedian $26 · 10th to 90th $9 to $186Professionalmedian $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 $5.37 Median $6.92 Typical High $45.71 | Facility | None | $5.37 | $6.92 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $6.17 Typical High $12.59 | Professional | None | $5.37 | $6.17 | $12.59 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $4.47 Typical High $9.12 | Professional | None | $3.16 | $4.47 | $9.12 |
BCBS Texas Setting Facility Modifier None Typical Low $10.00 Median $28.84 Typical High $60.26 | Facility | None | $10.00 | $28.84 | $60.26 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $7.24 | Professional | None | $5.01 | $5.13 | $7.24 |
Baylor Scott & White Setting Facility Modifier None Typical Low $6.31 Median $7.24 Typical High $12.30 | Facility | None | $6.31 | $7.24 | $12.30 |
Christus Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $19.50 Typical High $37.15 | Facility | None | $9.12 | $19.50 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $7.41 Typical High $16.22 | Professional | None | $5.13 | $7.41 | $16.22 |
Health Smart Setting Facility Modifier None Typical Low $13.80 Median $16.60 Typical High $16.60 | Facility | None | $13.80 | $16.60 | $16.60 |
Health Smart Setting Professional Modifier None Typical Low $7.76 Median $11.48 Typical High $16.60 | Professional | None | $7.76 | $11.48 | $16.60 |
Lucent Health Setting Professional Modifier None Typical Low $7.76 Median $11.22 Typical High $16.60 | Professional | None | $7.76 | $11.22 | $16.60 |
Moda Health Setting Facility Modifier None Typical Low $9.12 Median $104.71 Typical High $302.00 | Facility | None | $9.12 | $104.71 | $302.00 |
Moda Health Setting Professional Modifier None Typical Low $5.37 Median $7.59 Typical High $12.30 | Professional | None | $5.37 | $7.59 | $12.30 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | None | $6.76 | $7.59 | $7.59 |
Providence Setting Facility Modifier None Typical Low $7.24 Median $13.18 Typical High $37.15 | Facility | None | $7.24 | $13.18 | $37.15 |
Providence Setting Professional Modifier None Typical Low $5.13 Median $7.24 Typical High $15.49 | Professional | None | $5.13 | $7.24 | $15.49 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.80 Typical High $9.12 | Facility | None | $3.24 | $3.80 | $9.12 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.13 Typical High $7.41 | Professional | None | $3.80 | $5.13 | $7.41 |
Wellpoint Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | None | $4.47 | $4.47 | $4.68 |
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 $3.02 Median $6.46 Typical High $24.55 | Facility | 52 · Reduced service | $3.02 | $6.46 | $24.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.20 Median $2.57 Typical High $9.77 | Facility | 53 · Discontinued | $1.20 | $2.57 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.95 Typical High $5.37 | Professional | 52 · Reduced service | $2.69 | $2.95 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.20 Typical High $2.14 | Professional | 53 · Discontinued | $1.07 | $1.20 | $2.14 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.39 Median $6.46 Typical High $24.55 | Facility | 52 · Reduced service | $3.39 | $6.46 | $24.55 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.35 Median $2.57 Typical High $9.77 | Facility | 53 · Discontinued | $1.35 | $2.57 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.82 Typical High $4.37 | Professional | 52 · Reduced service | $2.69 | $2.82 | $4.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.12 Typical High $1.74 | Professional | 53 · Discontinued | $1.07 | $1.12 | $1.74 |
Where Texas sits
The same service costs 10.7 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· 34th of 51
$9.12
VT $74.13MD $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.