How much rates vary
Facilitymedian $17 · 10th to 90th $8 to $42Professionalmedian $9 · 10th to 90th $6 to $74
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 $6.46 Median $7.94 Typical High $24.55 | Facility | None | $6.46 | $7.94 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $11.22 | Professional | None | $5.25 | $7.08 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $9.33 | Professional | None | $6.46 | $8.13 | $9.33 |
BCBS Texas Setting Facility Modifier None Typical Low $11.48 Median $25.70 Typical High $46.77 | Facility | None | $11.48 | $25.70 | $46.77 |
BCBS Texas Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $15.14 | Professional | None | $5.75 | $7.41 | $15.14 |
Baylor Scott & White Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $13.49 | Professional | None | $8.32 | $9.12 | $13.49 |
Christus Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $11.75 | Facility | None | $8.51 | $8.51 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $9.55 Typical High $13.80 | Professional | None | $6.31 | $9.55 | $13.80 |
Health Smart Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $25.12 | Professional | None | $7.94 | $10.72 | $25.12 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | None | $74.13 | $79.43 | $79.43 |
Moda Health Setting Facility Modifier None Typical Low $6.46 Median $10.00 Typical High $40.74 | Facility | None | $6.46 | $10.00 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $14.79 | Professional | None | $5.25 | $7.94 | $14.79 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $6.46 Typical High $6.76 | Professional | None | $5.89 | $6.46 | $6.76 |
Oscar Health Setting Professional Modifier None Typical Low $8.51 Median $15.49 Typical High $19.50 | Professional | None | $8.51 | $15.49 | $19.50 |
Providence Setting Facility Modifier None Typical Low $6.46 Median $9.33 Typical High $13.18 | Facility | None | $6.46 | $9.33 | $13.18 |
Providence Setting Professional Modifier None Typical Low $6.31 Median $9.55 Typical High $13.80 | Professional | None | $6.31 | $9.55 | $13.80 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.51 Typical High $12.88 | Professional | None | $6.46 | $8.51 | $12.88 |
Wellpoint Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
12 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 $3.24 Median $3.98 Typical High $12.30 | Facility | 52 · Reduced service | $3.24 | $3.98 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.29 Median $1.58 Typical High $4.90 | Facility | 53 · Discontinued | $1.29 | $1.58 | $4.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $3.39 Typical High $4.47 | Professional | 52 · Reduced service | $2.63 | $3.39 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.35 Typical High $1.78 | Professional | 53 · Discontinued | $1.05 | $1.35 | $1.78 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $7.08 Median $8.13 Typical High $14.79 | Professional | 59 · Distinct service | $7.08 | $8.13 | $14.79 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $7.59 Median $8.13 Typical High $10.72 | Professional | 76 · Repeat, same provider | $7.59 | $8.13 | $10.72 |
Ambetter Setting Professional Modifier 77 · Repeat, other provider Typical Low $8.32 Median $8.32 Typical High $9.55 | Professional | 77 · Repeat, other provider | $8.32 | $8.32 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $3.39 Typical High $4.17 | Professional | 52 · Reduced service | $2.63 | $3.39 | $4.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.35 Typical High $1.70 | Professional | 53 · Discontinued | $1.05 | $1.35 | $1.70 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $7.59 Median $8.51 Typical High $31.62 | Professional | 59 · Distinct service | $7.59 | $8.51 | $31.62 |
Moda Health Setting Professional Modifier 76 · Repeat, same provider Typical Low $7.94 Median $8.51 Typical High $36.31 | Professional | 76 · Repeat, same provider | $7.94 | $8.51 | $36.31 |
Moda Health Setting Professional Modifier 77 · Repeat, other provider Typical Low $8.32 Median $13.80 Typical High $37.15 | Professional | 77 · Repeat, other provider | $8.32 | $13.80 | $37.15 |
Where Texas sits
The same service costs 2.5 times more in Alaska 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· 37th of 51
$9.33
AK $20.42MD $8.32
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.