How much rates vary
Facilitymedian $14 · 10th to 90th $6 to $74Professionalmedian $4 · 10th to 90th $3 to $7
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 $3.47 Median $5.25 Typical High $29.51 | Facility | None | $3.47 | $5.25 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.89 Typical High $7.94 | Professional | None | $3.47 | $3.89 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.88 Typical High $5.75 | Professional | None | $2.04 | $2.88 | $5.75 |
BCBS Texas Setting Facility Modifier None Typical Low $8.32 Median $21.38 Typical High $40.74 | Facility | None | $8.32 | $21.38 | $40.74 |
BCBS Texas Setting Professional Modifier None Typical Low $3.16 Median $5.01 Typical High $5.50 | Professional | None | $3.16 | $5.01 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $39.81 | Facility | None | $5.75 | $5.75 | $39.81 |
Christus Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $12.59 Typical High $23.99 | Facility | None | $5.75 | $12.59 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $4.47 Typical High $9.77 | Professional | None | $3.31 | $4.47 | $9.77 |
Health Smart Setting Facility Modifier None Typical Low $8.91 Median $10.47 Typical High $10.47 | Facility | None | $8.91 | $10.47 | $10.47 |
Health Smart Setting Professional Modifier None Typical Low $4.90 Median $7.41 Typical High $25.12 | Professional | None | $4.90 | $7.41 | $25.12 |
Lucent Health Setting Professional Modifier None Typical Low $4.90 Median $7.41 Typical High $25.12 | Professional | None | $4.90 | $7.41 | $25.12 |
Moda Health Setting Facility Modifier None Typical Low $4.57 Median $47.86 Typical High $138.04 | Facility | None | $4.57 | $47.86 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $3.47 Median $4.47 Typical High $7.94 | Professional | None | $3.47 | $4.47 | $7.94 |
Molina Setting Professional Modifier None Typical Low $4.37 Median $4.90 Typical High $4.90 | Professional | None | $4.37 | $4.90 | $4.90 |
Providence Setting Facility Modifier None Typical Low $4.57 Median $8.51 Typical High $23.99 | Facility | None | $4.57 | $8.51 | $23.99 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $4.17 Typical High $8.71 | Professional | None | $3.31 | $4.17 | $8.71 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.45 Typical High $5.75 | Facility | None | $2.09 | $2.45 | $5.75 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.31 Typical High $8.13 | Professional | None | $2.45 | $3.31 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
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 $1.95 Median $4.17 Typical High $15.49 | Facility | 52 · Reduced service | $1.95 | $4.17 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.78 Median $1.66 Typical High $6.31 | Facility | 53 · Discontinued | $0.78 | $1.66 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.91 Typical High $3.47 | Professional | 52 · Reduced service | $1.74 | $1.91 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.76 Typical High $1.38 | Professional | 53 · Discontinued | $0.69 | $0.76 | $1.38 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $2.88 Typical High $5.75 | Professional | QW · Waived lab test | $2.45 | $2.88 | $5.75 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.19 Median $4.17 Typical High $15.49 | Facility | 52 · Reduced service | $2.19 | $4.17 | $15.49 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.87 Median $1.66 Typical High $6.31 | Facility | 53 · Discontinued | $0.87 | $1.66 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.78 Typical High $2.82 | Professional | 52 · Reduced service | $1.74 | $1.78 | $2.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.72 Typical High $1.12 | Professional | 53 · Discontinued | $0.69 | $0.72 | $1.12 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $3.47 Median $5.75 Typical High $7.08 | Professional | QW · Waived lab test | $3.47 | $5.75 | $7.08 |
Where Texas sits
The same service costs 12.9 times more in Vermont than in Alabama. 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· 34th of 51
$5.62
VT $51.29AL $3.98
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.