How much rates vary
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 $15.85 Median $30.20 Typical High $128.82 | Facility | None | $15.85 | $30.20 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $33.11 | Professional | None | $14.13 | $16.98 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $21.88 | Professional | None | $12.30 | $12.59 | $21.88 |
BCBS Texas Setting Facility Modifier None Typical Low $28.18 Median $81.28 Typical High $165.96 | Facility | None | $28.18 | $81.28 | $165.96 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $14.13 Typical High $17.78 | Professional | None | $5.01 | $14.13 | $17.78 |
Christus Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $54.95 Typical High $104.71 | Facility | None | $25.70 | $54.95 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $42.66 | Professional | None | $14.45 | $18.20 | $42.66 |
Health Smart Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Health Smart Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $42.66 | Professional | None | $22.91 | $24.55 | $42.66 |
Lucent Health Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $42.66 | Professional | None | $22.91 | $24.55 | $42.66 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $38.02 Typical High $199.53 | Facility | None | $19.05 | $38.02 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $30.20 | Professional | None | $15.14 | $22.39 | $30.20 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $21.38 Typical High $21.38 | Professional | None | $19.05 | $21.38 | $21.38 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $38.02 Typical High $104.71 | Facility | None | $18.20 | $38.02 | $104.71 |
Providence Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $38.02 | Professional | None | $14.45 | $18.20 | $38.02 |
United Setting Facility Modifier None Typical Low $9.12 Median $10.72 Typical High $25.70 | Facility | None | $9.12 | $10.72 | $25.70 |
United Setting Professional Modifier None Typical Low $10.72 Median $14.45 Typical High $20.42 | Professional | None | $10.72 | $14.45 | $20.42 |
Wellpoint Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | None | $12.59 | $12.59 | $13.18 |
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 $8.32 Median $18.20 Typical High $69.18 | Facility | 52 · Reduced service | $8.32 | $18.20 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.39 Median $7.41 Typical High $27.54 | Facility | 53 · Discontinued | $3.39 | $7.41 | $27.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $7.94 Typical High $15.14 | Professional | 52 · Reduced service | $7.59 | $7.94 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.24 Typical High $6.03 | Professional | 53 · Discontinued | $3.02 | $3.24 | $6.03 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $9.55 Median $18.20 Typical High $69.18 | Facility | 52 · Reduced service | $9.55 | $18.20 | $69.18 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $3.89 Median $7.41 Typical High $27.54 | Facility | 53 · Discontinued | $3.89 | $7.41 | $27.54 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $17.38 Median $158.49 Typical High $199.53 | Facility | 59 · Distinct service | $17.38 | $158.49 | $199.53 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $34.67 Median $91.20 Typical High $128.82 | Facility | XU · Unusual separate service | $34.67 | $91.20 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.59 Median $7.94 Typical High $12.02 | Professional | 52 · Reduced service | $7.59 | $7.94 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.16 Typical High $4.79 | Professional | 53 · Discontinued | $3.02 | $3.16 | $4.79 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 59 · Distinct service | $22.91 | $22.91 | $22.91 |
Where Texas sits
The same service costs 4.6 times more in Alaska than in Alabama. 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· 21st of 51
$26.92
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.