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 $27.54 Median $33.11 Typical High $36.31 | Facility | None | $27.54 | $33.11 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $33.88 Typical High $46.77 | Professional | None | $27.54 | $33.88 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
BCBS Texas Setting Facility Modifier None Typical Low $51.29 Median $117.49 Typical High $204.17 | Facility | None | $51.29 | $117.49 | $204.17 |
BCBS Texas Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $63.10 | Professional | None | $29.51 | $29.51 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Facility | None | $37.15 | $37.15 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $66.07 | Professional | None | $33.88 | $39.81 | $66.07 |
Lucent Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $36.31 Typical High $54.95 | Facility | None | $29.51 | $36.31 | $54.95 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $34.67 Typical High $50.12 | Professional | None | $27.54 | $34.67 | $50.12 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $31.62 Typical High $37.15 | Professional | None | $5.37 | $31.62 | $37.15 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | None | $109.65 | $112.20 | $134.90 |
Providence Setting Facility Modifier None Typical Low $29.51 Median $41.69 Typical High $54.95 | Facility | None | $29.51 | $41.69 | $54.95 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $66.07 | Professional | None | $33.88 | $39.81 | $66.07 |
United Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Facility | None | $23.99 | $23.99 | $33.11 |
United Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $60.26 | Professional | None | $30.90 | $39.81 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
4 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 Professional Modifier 52 · Reduced service Typical Low $13.80 Median $16.60 Typical High $20.42 | Professional | 52 · Reduced service | $13.80 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.76 Typical High $8.13 | Professional | 53 · Discontinued | $5.50 | $6.76 | $8.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $16.60 Typical High $21.38 | Professional | 52 · Reduced service | $13.80 | $16.60 | $21.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.61 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $6.61 | $8.71 |
Where Texas sits
The same service costs 2.7 times more in Alaska than in New York. 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· 42nd of 51
$39.81
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.