How much rates vary
Facilitymedian $14 · 10th to 90th $7 to $47Professionalmedian $4 · 10th to 90th $3 to $7
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 $4.37 Median $9.33 Typical High $36.31 | Facility | None | $4.37 | $9.33 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $9.12 | Professional | None | $3.98 | $4.37 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.68 | Professional | None | $3.31 | $3.31 | $4.68 |
BCBS Texas Setting Facility Modifier None Typical Low $7.41 Median $21.88 Typical High $43.65 | Facility | None | $7.41 | $21.88 | $43.65 |
BCBS Texas Setting Professional Modifier None Typical Low $3.63 Median $5.01 Typical High $6.61 | Professional | None | $3.63 | $5.01 | $6.61 |
Christus Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $14.45 Typical High $27.54 | Facility | None | $6.76 | $14.45 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $11.22 | Professional | None | $3.89 | $4.79 | $11.22 |
Health Smart Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Health Smart Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | None | $10.23 | $10.23 | $10.72 |
Lucent Health Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $28.18 Typical High $85.11 | Facility | None | $6.17 | $28.18 | $85.11 |
Moda Health Setting Professional Modifier None Typical Low $3.98 Median $5.13 Typical High $7.94 | Professional | None | $3.98 | $5.13 | $7.94 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $5.62 | Professional | None | $5.01 | $5.62 | $5.62 |
Providence Setting Facility Modifier None Typical Low $5.37 Median $10.00 Typical High $26.92 | Facility | None | $5.37 | $10.00 | $26.92 |
Providence Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $10.00 | Professional | None | $3.89 | $4.79 | $10.00 |
United Setting Facility Modifier None Typical Low $2.40 Median $6.61 Typical High $15.14 | Facility | None | $2.40 | $6.61 | $15.14 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $5.50 | Professional | None | $2.82 | $3.80 | $5.50 |
Wellpoint Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | None | $3.31 | $3.31 | $3.47 |
9 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 $2.24 Median $4.79 Typical High $18.20 | Facility | 52 · Reduced service | $2.24 | $4.79 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.89 Median $1.91 Typical High $7.24 | Facility | 53 · Discontinued | $0.89 | $1.91 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.19 Typical High $3.98 | Professional | 52 · Reduced service | $2.00 | $2.19 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.87 Typical High $1.58 | Professional | 53 · Discontinued | $0.79 | $0.87 | $1.58 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.51 Median $4.79 Typical High $18.20 | Facility | 52 · Reduced service | $2.51 | $4.79 | $18.20 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.00 Median $1.91 Typical High $7.24 | Facility | 53 · Discontinued | $1.00 | $1.91 | $7.24 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $43.65 Median $46.77 Typical High $60.26 | Facility | XU · Unusual separate service | $43.65 | $46.77 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.09 Typical High $3.24 | Professional | 52 · Reduced service | $2.00 | $2.09 | $3.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.83 Typical High $1.29 | Professional | 53 · Discontinued | $0.79 | $0.83 | $1.29 |
Where Texas sits
The same service costs 11.0 times more in Vermont than in Kentucky. 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
$6.76
VT $45.71KY $4.17
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.