How much rates vary
Facilitymedian $17 · 10th to 90th $9 to $54Professionalmedian $5 · 10th to 90th $4 to $10
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 $5.62 Median $11.48 Typical High $45.71 | Facility | None | $5.62 | $11.48 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.75 Typical High $12.02 | Professional | None | $5.37 | $5.75 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.47 Typical High $4.47 | Professional | None | $4.27 | $4.47 | $4.47 |
BCBS Texas Setting Facility Modifier None Typical Low $10.96 Median $30.90 Typical High $58.88 | Facility | None | $10.96 | $30.90 | $58.88 |
BCBS Texas Setting Professional Modifier None Typical Low $4.90 Median $5.13 Typical High $8.71 | Professional | None | $4.90 | $5.13 | $8.71 |
Baylor Scott & White Setting Facility Modifier None Typical Low $8.13 Median $8.91 Typical High $29.51 | Facility | None | $8.13 | $8.91 | $29.51 |
Christus Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $19.50 Typical High $36.31 | Facility | None | $8.91 | $19.50 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $6.76 Typical High $14.79 | Professional | None | $5.01 | $6.76 | $14.79 |
Health Smart Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Health Smart Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.85 | Professional | None | $13.80 | $13.80 | $15.85 |
Lucent Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Moda Health Setting Facility Modifier None Typical Low $6.76 Median $14.13 Typical High $104.71 | Facility | None | $6.76 | $14.13 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $5.37 Median $6.61 Typical High $10.72 | Professional | None | $5.37 | $6.61 | $10.72 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $7.41 Typical High $7.41 | Professional | None | $6.61 | $7.41 | $7.41 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $13.18 Typical High $36.31 | Facility | None | $7.08 | $13.18 | $36.31 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $13.49 | Professional | None | $5.01 | $6.46 | $13.49 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.72 Typical High $8.91 | Facility | None | $3.24 | $3.72 | $8.91 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $7.24 | Professional | None | $3.72 | $5.13 | $7.24 |
Wellpoint Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
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 $2.95 Median $6.46 Typical High $23.99 | Facility | 52 · Reduced service | $2.95 | $6.46 | $23.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.20 Median $2.57 Typical High $9.55 | Facility | 53 · Discontinued | $1.20 | $2.57 | $9.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.95 Typical High $5.37 | Professional | 52 · Reduced service | $2.69 | $2.95 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.17 Typical High $2.14 | Professional | 53 · Discontinued | $1.07 | $1.17 | $2.14 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.39 Median $6.46 Typical High $23.99 | Facility | 52 · Reduced service | $3.39 | $6.46 | $23.99 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.35 Median $2.57 Typical High $9.55 | Facility | 53 · Discontinued | $1.35 | $2.57 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.75 Typical High $4.27 | Professional | 52 · Reduced service | $2.69 | $2.75 | $4.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.10 Typical High $1.74 | Professional | 53 · Discontinued | $1.07 | $1.10 | $1.74 |
Where Texas sits
The same service costs 4.3 times more in Kansas 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· 13th of 51
$11.75
KS $28.18MD $6.61
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.