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 $0.05 Median $0.05 Typical High $0.10 | Facility | None | $0.05 | $0.05 | $0.10 |
Aetna Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | None | $0.05 | $0.05 | $0.06 |
BCBS Texas Setting Facility Modifier None Typical Low $0.30 Median $0.78 Typical High $1.48 | Facility | None | $0.30 | $0.78 | $1.48 |
BCBS Texas Setting Professional Modifier None Typical Low $0.07 Median $0.07 Typical High $0.41 | Professional | None | $0.07 | $0.07 | $0.41 |
Cigna Setting Facility Modifier None Typical Low $0.05 Median $0.10 Typical High $0.18 | Facility | None | $0.05 | $0.10 | $0.18 |
Cigna Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | None | $0.05 | $0.05 | $0.05 |
Moda Health Setting Facility Modifier None Typical Low $0.14 Median $0.79 Typical High $3.98 | Facility | None | $0.14 | $0.79 | $3.98 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.28 Median $0.91 Typical High $3.24 | Facility | JZ · No drug discarded | $0.28 | $0.91 | $3.24 |
Moda Health Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.09 | Professional | None | $0.05 | $0.05 | $0.09 |
Molina Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | None | $0.05 | $0.05 | $0.06 |
Providence Setting Facility Modifier None Typical Low $0.05 Median $0.07 Typical High $0.43 | Facility | None | $0.05 | $0.07 | $0.43 |
Providence Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | None | $0.05 | $0.05 | $0.05 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | None | $0.05 | $0.05 | $0.05 |
Wellpoint Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
3 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 $0.03 Median $0.04 Typical High $0.05 | Facility | 52 · Reduced service | $0.03 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Where Texas sits
The same service costs 12.9 times more in Oklahoma than in Delaware. 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· 2nd of 51
$0.52
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.