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 $0.08 Median $0.09 Typical High $0.19 | Facility | None | $0.08 | $0.09 | $0.19 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.09 Typical High $0.10 | Professional | None | $0.08 | $0.09 | $0.10 |
BCBS Texas Setting Facility Modifier None Typical Low $0.12 Median $0.39 Typical High $0.81 | Facility | None | $0.12 | $0.39 | $0.81 |
BCBS Texas Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.16 Typical High $0.28 | Facility | None | $0.09 | $0.16 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Health Smart Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.26 | Professional | None | $0.22 | $0.22 | $0.26 |
Lucent Health Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.26 | Professional | None | $0.22 | $0.22 | $0.26 |
Moda Health Setting Facility Modifier None Typical Low $0.28 Median $0.85 Typical High $5.25 | Facility | None | $0.28 | $0.85 | $5.25 |
Moda Health Setting Professional Modifier None Typical Low $0.08 Median $0.09 Typical High $0.13 | Professional | None | $0.08 | $0.09 | $0.13 |
Molina Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | None | $0.06 | $0.06 | $0.07 |
Providence Setting Facility Modifier None Typical Low $0.09 Median $0.13 Typical High $0.78 | Facility | None | $0.09 | $0.13 | $0.78 |
Providence Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
United Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Wellpoint Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
7 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 $0.05 Median $0.07 Typical High $0.10 | Facility | 52 · Reduced service | $0.05 | $0.07 | $0.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 52 · Reduced service | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Moda Health Setting Facility Modifier JW · Drug discarded Typical Low $0.44 Median $1.45 Typical High $1.62 | Facility | JW · Drug discarded | $0.44 | $1.45 | $1.62 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.65 Median $1.45 Typical High $7.76 | Facility | JZ · No drug discarded | $0.65 | $1.45 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 52 · Reduced service | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 14.5 times more in Alaska than in New Jersey. 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
$0.45
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.