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 $0.10 Typical High $0.17 | Facility | None | $0.05 | $0.10 | $0.17 |
Aetna Setting Professional Modifier None Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | None | $0.05 | $0.06 | $0.08 |
Ambetter Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $8.91 | Professional | None | $5.01 | $7.08 | $8.91 |
BCBS Texas Setting Facility Modifier None Typical Low $0.08 Median $0.19 Typical High $0.38 | Facility | None | $0.08 | $0.19 | $0.38 |
BCBS Texas Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
Christus Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Facility | None | $0.25 | $0.25 | $0.25 |
Cigna Setting Facility Modifier None Typical Low $0.06 Median $0.12 Typical High $0.20 | Facility | None | $0.06 | $0.12 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.49 | Professional | None | $0.06 | $0.06 | $0.49 |
Health Smart 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 $0.08 Median $1.12 Typical High $5.75 | Facility | None | $0.08 | $1.12 | $5.75 |
Moda Health Setting Professional Modifier None Typical Low $0.05 Median $0.08 Typical High $0.09 | Professional | None | $0.05 | $0.08 | $0.09 |
Molina Setting Professional Modifier None Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | None | $0.05 | $0.06 | $0.08 |
Providence Setting Facility Modifier None Typical Low $0.06 Median $0.08 Typical High $0.51 | Facility | None | $0.06 | $0.08 | $0.51 |
Providence Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.49 | Professional | None | $0.06 | $0.06 | $0.49 |
United Setting Professional Modifier None Typical Low $0.03 Median $0.08 Typical High $0.08 | Professional | None | $0.03 | $0.08 | $0.08 |
Wellpoint Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | None | $0.06 | $0.07 | $0.07 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $5.01 Median $7.08 Typical High $7.94 | Professional | JZ · No drug discarded | $5.01 | $7.08 | $7.94 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | KX · Policy requirements met | $7.94 | $7.94 | $7.94 |
Where Texas sits
The same service costs 12.0 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· 14th of 51
$0.08
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.