How much rates vary
Facilitymedian $155 · 10th to 90th $56 to $363Professionalmedian $68 · 10th to 90th $14 to $158
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 $56.23 Median $72.44 Typical High $213.80 | Facility | None | $56.23 | $72.44 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $100.00 | Professional | None | $45.71 | $61.66 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $87.10 | Professional | None | $66.07 | $70.79 | $87.10 |
BCBS Texas Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $389.05 | Facility | None | $97.72 | $223.87 | $389.05 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $141.25 | Professional | None | $58.88 | $72.44 | $141.25 |
Baylor Scott & White Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $165.96 | Professional | None | $70.79 | $81.28 | $165.96 |
Christus Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $199.53 | Facility | None | $89.13 | $89.13 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $134.90 | Professional | None | $57.54 | $85.11 | $134.90 |
Health Smart Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $81.28 Typical High $239.88 | Facility | None | $56.23 | $81.28 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $109.65 | Professional | None | $45.71 | $64.57 | $109.65 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $57.54 Typical High $70.79 | Professional | None | $10.23 | $57.54 | $70.79 |
Oscar Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $3,311.31 | Facility | None | $2,511.89 | $3,311.31 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $158.49 | Professional | None | $39.81 | $77.62 | $158.49 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $141.25 | Facility | None | $56.23 | $85.11 | $141.25 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $131.83 | Professional | None | $57.54 | $85.11 | $131.83 |
United Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $128.82 | Professional | None | $54.95 | $75.86 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
10 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 $28.18 Median $36.31 Typical High $107.15 | Facility | 52 · Reduced service | $28.18 | $36.31 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $42.66 | Facility | 53 · Discontinued | $11.22 | $14.45 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $29.51 Typical High $40.74 | Professional | 52 · Reduced service | $22.91 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.75 Typical High $16.22 | Professional | 53 · Discontinued | $9.33 | $11.75 | $16.22 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 51 · Multiple procedures | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | 59 · Distinct service | $56.23 | $66.07 | $70.79 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | XU · Unusual separate service | $69.18 | $69.18 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $28.84 Typical High $37.15 | Professional | 52 · Reduced service | $22.91 | $28.84 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.48 Typical High $15.14 | Professional | 53 · Discontinued | $9.33 | $11.48 | $15.14 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $74.13 Median $83.18 Typical High $97.72 | Professional | 59 · Distinct service | $74.13 | $83.18 | $97.72 |
Where Texas sits
The same service costs 2.7 times more in Minnesota than in Florida. 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· 49th of 51
$67.61
MN $166FL $61.66
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.