How much rates vary
Facilitymedian $11 · 10th to 90th $6 to $58Professionalmedian $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 $3.55 Median $6.46 Typical High $28.84 | Facility | None | $3.55 | $6.46 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $7.94 | Professional | None | $3.39 | $3.80 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $5.62 | Professional | None | $2.82 | $2.82 | $5.62 |
BCBS Texas Setting Facility Modifier None Typical Low $6.31 Median $19.05 Typical High $38.02 | Facility | None | $6.31 | $19.05 | $38.02 |
BCBS Texas Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $5.50 | Professional | None | $3.09 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $12.30 Typical High $23.44 | Facility | None | $5.75 | $12.30 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $4.17 Typical High $9.33 | Professional | None | $3.16 | $4.17 | $9.33 |
Health Smart Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Health Smart Setting Professional Modifier None Typical Low $5.13 Median $8.51 Typical High $9.55 | Professional | None | $5.13 | $8.51 | $9.55 |
Lucent Health Setting Professional Modifier None Typical Low $5.13 Median $5.37 Typical High $9.55 | Professional | None | $5.13 | $5.37 | $9.55 |
Moda Health Setting Facility Modifier None Typical Low $4.27 Median $26.30 Typical High $190.55 | Facility | None | $4.27 | $26.30 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $6.76 | Professional | None | $3.39 | $4.90 | $6.76 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $4.79 | Professional | None | $4.27 | $4.79 | $4.79 |
Providence Setting Facility Modifier None Typical Low $4.57 Median $8.32 Typical High $23.44 | Facility | None | $4.57 | $8.32 | $23.44 |
Providence Setting Professional Modifier None Typical Low $3.16 Median $4.17 Typical High $8.51 | Professional | None | $3.16 | $4.17 | $8.51 |
United Setting Facility Modifier None Typical Low $2.04 Median $2.40 Typical High $5.62 | Facility | None | $2.04 | $2.40 | $5.62 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.24 Typical High $5.25 | Professional | None | $2.40 | $3.24 | $5.25 |
Wellpoint Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.95 | Professional | None | $2.82 | $2.82 | $2.95 |
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 $1.91 Median $4.07 Typical High $15.49 | Facility | 52 · Reduced service | $1.91 | $4.07 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.76 Median $1.62 Typical High $6.17 | Facility | 53 · Discontinued | $0.76 | $1.62 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $1.86 Typical High $3.39 | Professional | 52 · Reduced service | $1.70 | $1.86 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.76 Typical High $1.35 | Professional | 53 · Discontinued | $0.68 | $0.76 | $1.35 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.14 Median $4.07 Typical High $15.49 | Facility | 52 · Reduced service | $2.14 | $4.07 | $15.49 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.85 Median $1.62 Typical High $6.17 | Facility | 53 · Discontinued | $0.85 | $1.62 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $1.78 Typical High $2.75 | Professional | 52 · Reduced service | $1.70 | $1.78 | $2.75 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.71 Typical High $1.10 | Professional | 53 · Discontinued | $0.68 | $0.71 | $1.10 |
Where Texas sits
The same service costs 13.5 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· 29th of 51
$5.62
VT $57.54MD $4.27
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.