How much rates vary
Facilitymedian $47 · 10th to 90th $17 to $93Professionalmedian $10 · 10th to 90th $5 to $18
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 $11.75 Median $25.70 Typical High $91.20 | Facility | None | $11.75 | $25.70 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $21.38 | Professional | None | $10.72 | $11.75 | $21.38 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $12.59 Typical High $17.78 | Professional | None | $8.71 | $12.59 | $17.78 |
BCBS Texas Setting Facility Modifier None Typical Low $22.39 Median $61.66 Typical High $102.33 | Facility | None | $22.39 | $61.66 | $102.33 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $9.77 Typical High $12.59 | Professional | None | $5.01 | $9.77 | $12.59 |
Christus Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $38.90 Typical High $56.23 | Facility | None | $14.45 | $38.90 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $30.90 | Professional | None | $9.55 | $13.80 | $30.90 |
Health Smart Setting Professional Modifier None Typical Low $15.14 Median $16.98 Typical High $26.92 | Professional | None | $15.14 | $16.98 | $26.92 |
Lucent Health Setting Professional Modifier None Typical Low $15.85 Median $16.98 Typical High $29.51 | Professional | None | $15.85 | $16.98 | $29.51 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $17.78 Typical High $66.07 | Facility | None | $13.18 | $17.78 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $10.72 Median $12.88 Typical High $22.39 | Professional | None | $10.72 | $12.88 | $22.39 |
Molina Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | None | $13.49 | $15.14 | $15.14 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $19.50 Typical High $56.23 | Facility | None | $13.49 | $19.50 | $56.23 |
Providence Setting Professional Modifier None Typical Low $9.55 Median $13.49 Typical High $31.62 | Professional | None | $9.55 | $13.49 | $31.62 |
United Setting Facility Modifier None Typical Low $6.46 Median $17.78 Typical High $18.20 | Facility | None | $6.46 | $17.78 | $18.20 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.33 Typical High $11.75 | Professional | None | $7.59 | $9.33 | $11.75 |
Wellpoint Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | None | $8.91 | $8.91 | $9.33 |
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 $5.89 Median $12.88 Typical High $48.98 | Facility | 52 · Reduced service | $5.89 | $12.88 | $48.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.34 Median $5.13 Typical High $19.50 | Facility | 53 · Discontinued | $2.34 | $5.13 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.89 Typical High $10.72 | Professional | 52 · Reduced service | $5.37 | $5.89 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.34 Typical High $4.27 | Professional | 53 · Discontinued | $2.14 | $2.34 | $4.27 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $6.76 Median $12.88 Typical High $48.98 | Facility | 52 · Reduced service | $6.76 | $12.88 | $48.98 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.69 Median $5.13 Typical High $19.50 | Facility | 53 · Discontinued | $2.69 | $5.13 | $19.50 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $36.31 Median $47.86 Typical High $74.13 | Facility | XU · Unusual separate service | $36.31 | $47.86 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.62 Typical High $8.71 | Professional | 52 · Reduced service | $5.37 | $5.62 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.24 Typical High $3.47 | Professional | 53 · Discontinued | $2.14 | $2.24 | $3.47 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $15.49 Median $15.85 Typical High $17.78 | Professional | 59 · Distinct service | $15.49 | $15.85 | $17.78 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Georgia. 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· 12th of 51
$21.38
AK $40.74GA $12.30
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.