How much rates vary
Facilitymedian $10 · 10th to 90th $5 to $32Professionalmedian $4 · 10th to 90th $3 to $6
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 $3.24 Median $6.46 Typical High $26.30 | Facility | None | $3.24 | $6.46 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.47 Typical High $7.08 | Professional | None | $3.09 | $3.47 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $3.24 Typical High $5.25 | Professional | None | $1.82 | $3.24 | $5.25 |
BCBS Texas Setting Facility Modifier None Typical Low $6.76 Median $18.20 Typical High $34.67 | Facility | None | $6.76 | $18.20 | $34.67 |
BCBS Texas Setting Professional Modifier None Typical Low $2.88 Median $5.01 Typical High $5.50 | Professional | None | $2.88 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $11.22 Typical High $21.38 | Facility | None | $5.25 | $11.22 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $8.71 | Professional | None | $2.95 | $3.80 | $8.71 |
Health Smart Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Health Smart Setting Professional Modifier None Typical Low $4.37 Median $6.61 Typical High $10.23 | Professional | None | $4.37 | $6.61 | $10.23 |
Lucent Health Setting Professional Modifier None Typical Low $4.37 Median $6.61 Typical High $11.22 | Professional | None | $4.37 | $6.61 | $11.22 |
Moda Health Setting Facility Modifier None Typical Low $3.98 Median $9.77 Typical High $43.65 | Facility | None | $3.98 | $9.77 | $43.65 |
Moda Health Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $6.61 | Professional | None | $3.09 | $4.47 | $6.61 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $4.37 Typical High $4.37 | Professional | None | $3.89 | $4.37 | $4.37 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $7.76 Typical High $21.38 | Facility | None | $4.17 | $7.76 | $21.38 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $7.76 | Professional | None | $2.95 | $3.80 | $7.76 |
United Setting Facility Modifier None Typical Low $1.86 Median $2.19 Typical High $5.25 | Facility | None | $1.86 | $2.19 | $5.25 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.02 Typical High $4.27 | Professional | None | $2.19 | $3.02 | $4.27 |
Wellpoint Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | None | $2.57 | $2.57 | $2.69 |
10 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 $1.74 Median $3.80 Typical High $14.13 | Facility | 52 · Reduced service | $1.74 | $3.80 | $14.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.71 Median $1.51 Typical High $5.62 | Facility | 53 · Discontinued | $0.71 | $1.51 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.74 Typical High $3.16 | Professional | 52 · Reduced service | $1.58 | $1.74 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.69 Typical High $1.26 | Professional | 53 · Discontinued | $0.63 | $0.69 | $1.26 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.95 Median $3.80 Typical High $14.13 | Facility | 52 · Reduced service | $1.95 | $3.80 | $14.13 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.79 Median $1.51 Typical High $5.62 | Facility | 53 · Discontinued | $0.79 | $1.51 | $5.62 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $21.38 Median $40.74 Typical High $50.12 | Facility | 59 · Distinct service | $21.38 | $40.74 | $50.12 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $21.38 Median $21.88 Typical High $38.90 | Facility | XU · Unusual separate service | $21.38 | $21.88 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.62 Typical High $2.51 | Professional | 52 · Reduced service | $1.58 | $1.62 | $2.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.65 Typical High $1.00 | Professional | 53 · Discontinued | $0.63 | $0.65 | $1.00 |
Where Texas sits
The same service costs 4.5 times more in Alaska 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· 17th of 51
$6.76
AK $17.38MD $3.89
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.