How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $20Professionalmedian $3 · 10th to 90th $2 to $5
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 $2.14 Median $4.17 Typical High $17.78 | Facility | None | $2.14 | $4.17 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $4.79 | Professional | None | $2.04 | $2.29 | $4.79 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $3.80 | Professional | None | $1.74 | $1.74 | $3.80 |
BCBS Texas Setting Facility Modifier None Typical Low $4.79 Median $12.30 Typical High $23.44 | Facility | None | $4.79 | $12.30 | $23.44 |
BCBS Texas Setting Professional Modifier None Typical Low $2.24 Median $5.01 Typical High $5.50 | Professional | None | $2.24 | $5.01 | $5.50 |
Baylor Scott & White Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Christus Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $7.24 Typical High $10.96 | Facility | None | $2.82 | $7.24 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $1.70 Median $2.88 Typical High $5.13 | Professional | None | $1.70 | $2.88 | $5.13 |
Health Smart Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Health Smart Setting Professional Modifier None Typical Low $3.02 Median $4.17 Typical High $6.31 | Professional | None | $3.02 | $4.17 | $6.31 |
Lucent Health Setting Professional Modifier None Typical Low $3.02 Median $4.17 Typical High $6.31 | Professional | None | $3.02 | $4.17 | $6.31 |
Moda Health Setting Facility Modifier None Typical Low $2.57 Median $4.17 Typical High $37.15 | Facility | None | $2.57 | $4.17 | $37.15 |
Moda Health Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $4.27 | Professional | None | $2.09 | $2.63 | $4.27 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $2.95 Typical High $2.95 | Professional | None | $2.63 | $2.95 | $2.95 |
Providence Setting Facility Modifier None Typical Low $2.51 Median $4.17 Typical High $10.96 | Facility | None | $2.51 | $4.17 | $10.96 |
Providence Setting Professional Modifier None Typical Low $1.70 Median $2.88 Typical High $4.47 | Professional | None | $1.70 | $2.88 | $4.47 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.45 Typical High $3.47 | Facility | None | $1.26 | $1.45 | $3.47 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $3.47 | Professional | None | $2.09 | $2.09 | $3.47 |
Wellpoint Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
10 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 $1.17 Median $2.51 Typical High $9.33 | Facility | 52 · Reduced service | $1.17 | $2.51 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.47 Median $1.00 Typical High $3.80 | Facility | 53 · Discontinued | $0.47 | $1.00 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.05 Median $1.15 Typical High $2.09 | Professional | 52 · Reduced service | $1.05 | $1.15 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.46 Typical High $0.83 | Professional | 53 · Discontinued | $0.42 | $0.46 | $0.83 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $1.48 Median $1.48 Typical High $3.47 | Professional | 59 · Distinct service | $1.48 | $1.48 | $3.47 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.48 Median $1.74 Typical High $5.37 | Professional | QW · Waived lab test | $1.48 | $1.74 | $5.37 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.32 Median $2.51 Typical High $9.33 | Facility | 52 · Reduced service | $1.32 | $2.51 | $9.33 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.52 Median $1.00 Typical High $3.80 | Facility | 53 · Discontinued | $0.52 | $1.00 | $3.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.05 Median $1.07 Typical High $1.70 | Professional | 52 · Reduced service | $1.05 | $1.07 | $1.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.43 Typical High $0.68 | Professional | 53 · Discontinued | $0.42 | $0.43 | $0.68 |
Where Texas sits
The same service costs 3.5 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· 24th of 51
$3.47
AK $9.55NJ $2.75
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.