How much rates vary
Facilitymedian $11 · 10th to 90th $6 to $34Professionalmedian $4 · 10th to 90th $3 to $6
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 $3.89 Median $8.13 Typical High $33.88 | Facility | None | $3.89 | $8.13 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $8.32 | Professional | None | $3.72 | $4.07 | $8.32 |
Ambetter Setting Professional Modifier None Typical Low $3.09 Median $6.17 Typical High $6.17 | Professional | None | $3.09 | $6.17 | $6.17 |
BCBS Texas Setting Facility Modifier None Typical Low $8.51 Median $21.88 Typical High $41.69 | Facility | None | $8.51 | $21.88 | $41.69 |
BCBS Texas Setting Professional Modifier None Typical Low $3.47 Median $5.01 Typical High $5.50 | Professional | None | $3.47 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $13.18 Typical High $19.50 | Facility | None | $5.01 | $13.18 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $10.47 | Professional | None | $3.09 | $5.01 | $10.47 |
Health Smart Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Health Smart Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | None | $6.92 | $6.92 | $7.08 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Moda Health Setting Facility Modifier None Typical Low $4.37 Median $6.17 Typical High $29.51 | Facility | None | $4.37 | $6.17 | $29.51 |
Moda Health Setting Professional Modifier None Typical Low $3.72 Median $4.07 Typical High $7.59 | Professional | None | $3.72 | $4.07 | $7.59 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $5.25 Typical High $5.25 | Professional | None | $4.68 | $5.25 | $5.25 |
Providence Setting Facility Modifier None Typical Low $4.47 Median $7.41 Typical High $19.50 | Facility | None | $4.47 | $7.41 | $19.50 |
Providence Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $10.47 | Professional | None | $3.09 | $5.01 | $10.47 |
United Setting Facility Modifier None Typical Low $2.24 Median $2.63 Typical High $6.17 | Facility | None | $2.24 | $2.63 | $6.17 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $6.17 | Professional | None | $2.95 | $3.72 | $6.17 |
Wellpoint Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
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 $2.09 Median $4.47 Typical High $16.98 | Facility | 52 · Reduced service | $2.09 | $4.47 | $16.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.83 Median $1.82 Typical High $6.76 | Facility | 53 · Discontinued | $0.83 | $1.82 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $2.04 Typical High $3.72 | Professional | 52 · Reduced service | $1.86 | $2.04 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.81 Typical High $1.51 | Professional | 53 · Discontinued | $0.76 | $0.81 | $1.51 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.63 Median $3.09 Typical High $6.17 | Professional | QW · Waived lab test | $2.63 | $3.09 | $6.17 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.34 Median $4.47 Typical High $16.98 | Facility | 52 · Reduced service | $2.34 | $4.47 | $16.98 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.93 Median $1.82 Typical High $6.76 | Facility | 53 · Discontinued | $0.93 | $1.82 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $1.95 Typical High $3.02 | Professional | 52 · Reduced service | $1.86 | $1.95 | $3.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.78 Typical High $1.20 | Professional | 53 · Discontinued | $0.76 | $0.78 | $1.20 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $3.98 Median $6.17 Typical High $8.71 | Professional | QW · Waived lab test | $3.98 | $6.17 | $8.71 |
Where Texas sits
The same service costs 3.5 times more in Alaska 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· 22nd of 51
$6.17
AK $14.13AL $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.