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 $0.08 Typical High $0.19 | Facility | None | $0.08 | $0.08 | $0.19 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.12 | Professional | None | $0.08 | $0.08 | $0.12 |
BCBS Texas Setting Facility Modifier None Typical Low $0.07 Median $0.17 Typical High $0.30 | Facility | None | $0.07 | $0.17 | $0.30 |
BCBS Texas Setting Professional Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | None | $0.03 | $0.03 | $0.03 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.11 Typical High $0.28 | Facility | None | $0.09 | $0.11 | $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 |
Lucent Health Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Moda Health Setting Facility Modifier None Typical Low $0.08 Median $1.35 Typical High $9.55 | Facility | None | $0.08 | $1.35 | $9.55 |
Moda Health Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.10 | Professional | None | $0.08 | $0.08 | $0.10 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier None Typical Low $6.46 Median $7.76 Typical High $9.33 | Professional | None | $6.46 | $7.76 | $9.33 |
Providence Setting Facility Modifier None Typical Low $0.04 Median $0.11 Typical High $0.78 | Facility | None | $0.04 | $0.11 | $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 $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
Wellpoint Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
6 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 $0.04 Median $0.04 Typical High $0.04 | Professional | 52 · Reduced service | $0.04 | $0.04 | $0.04 |
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 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 52 · Reduced service | $0.04 | $0.04 | $0.04 |
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 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 14.8 times more in Montana than in Hawaii. 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· 17th of 51
$0.09
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.