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 $2.51 Median $3.09 Typical High $3.39 | Facility | None | $2.51 | $3.09 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.09 Typical High $5.62 | Professional | None | $2.51 | $3.09 | $5.62 |
BCBS Texas Setting Facility Modifier None Typical Low $4.79 Median $11.75 Typical High $22.91 | Facility | None | $4.79 | $11.75 | $22.91 |
BCBS Texas Setting Professional Modifier None Typical Low $3.47 Median $4.79 Typical High $6.61 | Professional | None | $3.47 | $4.79 | $6.61 |
Baylor Scott & White Setting Facility Modifier None Typical Low $3.55 Median $93.33 Typical High $229.09 | Facility | None | $3.55 | $93.33 | $229.09 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $44.67 Typical High $56.23 | Professional | None | $14.79 | $44.67 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $104.71 Typical High $323.59 | Facility | None | $3.55 | $104.71 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $2.51 Median $3.09 Typical High $5.62 | Professional | None | $2.51 | $3.09 | $5.62 |
Molina Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $3.39 | Professional | None | $2.95 | $3.24 | $3.39 |
Oscar Health Setting Professional Modifier None Typical Low $4.37 Median $8.32 Typical High $10.96 | Professional | None | $4.37 | $8.32 | $10.96 |
Providence Setting Facility Modifier None Typical Low $3.09 Median $4.37 Typical High $6.31 | Facility | None | $3.09 | $4.37 | $6.31 |
Providence Setting Professional Modifier None Typical Low $5.75 Median $21.38 Typical High $56.23 | Professional | None | $5.75 | $21.38 | $56.23 |
United Setting Professional Modifier None Typical Low $3.16 Median $4.27 Typical High $7.08 | Professional | None | $3.16 | $4.27 | $7.08 |
Wellpoint Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
5 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 $1.26 Median $1.51 Typical High $2.29 | Professional | 52 · Reduced service | $1.26 | $1.51 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.62 Typical High $0.91 | Professional | 53 · Discontinued | $0.50 | $0.62 | $0.91 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | 59 · Distinct service | $4.07 | $4.07 | $4.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.51 Typical High $1.91 | Professional | 52 · Reduced service | $1.26 | $1.51 | $1.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.62 Typical High $0.78 | Professional | 53 · Discontinued | $0.50 | $0.62 | $0.78 |
Where Texas sits
The same service costs 2.3 times more in Kansas than in Pennsylvania. 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· 30th of 51
$5.01
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.