How much rates vary
Facilitymedian $11 · 10th to 90th $5 to $55Professionalmedian $3 · 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 $3.39 Median $7.08 Typical High $28.18 | Facility | None | $3.39 | $7.08 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.47 Typical High $6.76 | Professional | None | $3.09 | $3.47 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.69 Typical High $3.16 | Professional | None | $2.29 | $2.69 | $3.16 |
BCBS Texas Setting Facility Modifier None Typical Low $5.75 Median $16.60 Typical High $33.88 | Facility | None | $5.75 | $16.60 | $33.88 |
BCBS Texas Setting Professional Modifier None Typical Low $2.82 Median $5.01 Typical High $5.50 | Professional | None | $2.82 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $11.22 Typical High $21.38 | Facility | None | $5.25 | $11.22 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $8.51 | Professional | None | $2.95 | $3.80 | $8.51 |
Health Smart Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Health Smart Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $8.13 | Professional | None | $4.68 | $4.90 | $8.13 |
Lucent Health Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $8.51 | Professional | None | $4.68 | $4.90 | $8.51 |
Moda Health Setting Facility Modifier None Typical Low $4.68 Median $45.71 Typical High $114.82 | Facility | None | $4.68 | $45.71 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $3.09 Median $3.98 Typical High $6.03 | Professional | None | $3.09 | $3.98 | $6.03 |
Molina Setting Professional Modifier None Typical Low $3.89 Median $4.37 Typical High $4.37 | Professional | None | $3.89 | $4.37 | $4.37 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $7.59 Typical High $21.38 | Facility | None | $4.17 | $7.59 | $21.38 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $7.59 | Professional | None | $2.95 | $3.80 | $7.59 |
United Setting Facility Modifier None Typical Low $1.86 Median $5.13 Typical High $8.91 | Facility | None | $1.86 | $5.13 | $8.91 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.95 Typical High $4.27 | Professional | None | $2.19 | $2.95 | $4.27 |
Wellpoint Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | None | $2.57 | $2.57 | $2.69 |
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 $1.74 Median $3.72 Typical High $14.13 | Facility | 52 · Reduced service | $1.74 | $3.72 | $14.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.69 Median $1.48 Typical High $5.62 | Facility | 53 · Discontinued | $0.69 | $1.48 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.70 Typical High $3.09 | Professional | 52 · Reduced service | $1.55 | $1.70 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.68 Typical High $1.23 | Professional | 53 · Discontinued | $0.62 | $0.68 | $1.23 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.95 Median $3.72 Typical High $14.13 | Facility | 52 · Reduced service | $1.95 | $3.72 | $14.13 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.78 Median $1.48 Typical High $5.62 | Facility | 53 · Discontinued | $0.78 | $1.48 | $5.62 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $23.99 Median $107.15 Typical High $177.83 | Facility | 59 · Distinct service | $23.99 | $107.15 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.62 Typical High $2.51 | Professional | 52 · Reduced service | $1.55 | $1.62 | $2.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.65 Typical High $1.00 | Professional | 53 · Discontinued | $0.62 | $0.65 | $1.00 |
Where Texas sits
The same service costs 9.3 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· 27th of 51
$5.50
VT $36.31MD $3.89
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.