How much rates vary
Facilitymedian $11 · 10th to 90th $5 to $36Professionalmedian $4 · 10th to 90th $3 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 $3.47 Median $7.59 Typical High $29.51 | Facility | None | $3.47 | $7.59 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $7.59 | Professional | None | $3.31 | $3.63 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $2.63 Median $3.39 Typical High $5.50 | Professional | None | $2.63 | $3.39 | $5.50 |
BCBS Texas Setting Facility Modifier None Typical Low $8.32 Median $20.89 Typical High $38.90 | Facility | None | $8.32 | $20.89 | $38.90 |
BCBS Texas Setting Professional Modifier None Typical Low $3.02 Median $5.01 Typical High $5.50 | Professional | None | $3.02 | $5.01 | $5.50 |
Baylor Scott & White Setting Professional Modifier None Typical Low $3.89 Median $5.01 Typical High $7.76 | Professional | None | $3.89 | $5.01 | $7.76 |
Christus Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $12.02 Typical High $23.44 | Facility | None | $5.50 | $12.02 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $3.98 Typical High $9.33 | Professional | None | $3.16 | $3.98 | $9.33 |
Health Smart Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Health Smart Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | None | $8.51 | $8.51 | $8.71 |
Lucent Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Moda Health Setting Facility Modifier None Typical Low $4.37 Median $10.23 Typical High $85.11 | Facility | None | $4.37 | $10.23 | $85.11 |
Moda Health Setting Professional Modifier None Typical Low $3.31 Median $4.17 Typical High $6.61 | Professional | None | $3.31 | $4.17 | $6.61 |
Molina Setting Professional Modifier None Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | None | $4.17 | $4.68 | $4.68 |
Providence Setting Facility Modifier None Typical Low $4.47 Median $8.13 Typical High $23.44 | Facility | None | $4.47 | $8.13 | $23.44 |
Providence Setting Professional Modifier None Typical Low $3.16 Median $3.98 Typical High $8.32 | Professional | None | $3.16 | $3.98 | $8.32 |
United Setting Facility Modifier None Typical Low $2.00 Median $5.50 Typical High $12.02 | Facility | None | $2.00 | $5.50 | $12.02 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.16 Typical High $4.47 | Professional | None | $2.29 | $3.16 | $4.47 |
Wellpoint Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.82 | Professional | None | $2.69 | $2.69 | $2.82 |
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 $1.86 Median $3.98 Typical High $14.79 | Facility | 52 · Reduced service | $1.86 | $3.98 | $14.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.74 Median $1.58 Typical High $6.03 | Facility | 53 · Discontinued | $0.74 | $1.58 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.82 Typical High $3.31 | Professional | 52 · Reduced service | $1.66 | $1.82 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.72 Typical High $1.32 | Professional | 53 · Discontinued | $0.66 | $0.72 | $1.32 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.09 Median $3.98 Typical High $14.79 | Facility | 52 · Reduced service | $2.09 | $3.98 | $14.79 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.83 Median $1.58 Typical High $6.03 | Facility | 53 · Discontinued | $0.83 | $1.58 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.70 Typical High $2.69 | Professional | 52 · Reduced service | $1.66 | $1.70 | $2.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.68 Typical High $1.07 | Professional | 53 · Discontinued | $0.66 | $0.68 | $1.07 |
Where Texas sits
The same service costs 12.3 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· 27th of 51
$5.75
VT $51.29MD $4.17
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.