How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $5Professionalmedian $0 · 10th to 90th $0 to $4
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 $0.32 Median $0.34 Typical High $0.44 | Facility | None | $0.32 | $0.34 | $0.44 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.34 Typical High $0.44 | Professional | None | $0.32 | $0.34 | $0.44 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
BCBS Texas Setting Facility Modifier None Typical Low $0.37 Median $0.49 Typical High $1.41 | Facility | None | $0.37 | $0.49 | $1.41 |
BCBS Texas Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Baylor Scott & White Setting Facility Modifier None Typical Low $0.33 Median $0.41 Typical High $40.74 | Facility | None | $0.33 | $0.41 | $40.74 |
Baylor Scott & White Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Christus Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Lucent Health Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Moda Health Setting Facility Modifier None Typical Low $0.34 Median $0.54 Typical High $19.95 | Facility | None | $0.34 | $0.54 | $19.95 |
Moda Health Setting Professional Modifier None Typical Low $0.32 Median $0.34 Typical High $0.46 | Professional | None | $0.32 | $0.34 | $0.46 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.35 Median $0.54 Typical High $0.56 | Facility | None | $0.35 | $0.54 | $0.56 |
Providence Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.28 Typical High $0.38 | Professional | None | $0.22 | $0.28 | $0.38 |
Wellpoint Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
11 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 $0.16 Median $0.18 Typical High $0.23 | Professional | 52 · Reduced service | $0.16 | $0.18 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.07 Typical High $0.09 | Professional | 53 · Discontinued | $0.06 | $0.07 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | RR · Rental | $0.03 | $0.04 | $0.05 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | Q6 · Substitute physician, paid per time | $26.92 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.16 Median $0.18 Typical High $0.22 | Professional | 52 · Reduced service | $0.16 | $0.18 | $0.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.07 Typical High $0.09 | Professional | 53 · Discontinued | $0.06 | $0.07 | $0.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.05 |
Moda Health Setting Professional Modifier RR · Rental Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | RR · Rental | $0.03 | $0.04 | $0.04 |
Where Texas sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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
$0.35
HI $1.05RI $0.23
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.