How much rates vary
Facilitymedian $14 · 10th to 90th $5 to $123Professionalmedian $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 $3.16 Median $5.37 Typical High $26.30 | Facility | None | $3.16 | $5.37 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.39 Typical High $6.92 | Professional | None | $3.09 | $3.39 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $1.78 Median $2.57 Typical High $3.47 | Professional | None | $1.78 | $2.57 | $3.47 |
BCBS Texas Setting Facility Modifier None Typical Low $5.62 Median $16.60 Typical High $33.88 | Facility | None | $5.62 | $16.60 | $33.88 |
BCBS Texas Setting Professional Modifier None Typical Low $2.82 Median $5.01 Typical High $5.50 | Professional | None | $2.82 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $11.22 Typical High $21.38 | Facility | None | $5.13 | $11.22 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $4.90 Typical High $9.12 | Professional | None | $2.95 | $4.90 | $9.12 |
Health Smart Setting Facility Modifier None Typical Low $7.94 Median $9.55 Typical High $9.55 | Facility | None | $7.94 | $9.55 | $9.55 |
Health Smart Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $15.85 | Professional | None | $4.47 | $7.24 | $15.85 |
Lucent Health Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $15.85 | Professional | None | $4.47 | $7.24 | $15.85 |
Moda Health Setting Facility Modifier None Typical Low $5.13 Median $58.88 Typical High $316.23 | Facility | None | $5.13 | $58.88 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $3.09 Median $4.57 Typical High $16.22 | Professional | None | $3.09 | $4.57 | $16.22 |
Molina Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Providence Setting Facility Modifier None Typical Low $4.07 Median $7.59 Typical High $21.38 | Facility | None | $4.07 | $7.59 | $21.38 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $4.27 Typical High $8.71 | Professional | None | $2.95 | $4.27 | $8.71 |
United Setting Facility Modifier None Typical Low $1.82 Median $5.13 Typical High $10.47 | Facility | None | $1.82 | $5.13 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.95 Typical High $4.17 | Professional | None | $2.14 | $2.95 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
12 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 $1.74 Median $3.72 Typical High $13.80 | Facility | 52 · Reduced service | $1.74 | $3.72 | $13.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.69 Median $1.48 Typical High $5.50 | Facility | 53 · Discontinued | $0.69 | $1.48 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.70 Typical High $3.09 | Professional | 52 · Reduced service | $1.55 | $1.70 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.68 Typical High $1.23 | Professional | 53 · Discontinued | $0.62 | $0.68 | $1.23 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.95 Median $3.72 Typical High $13.80 | Facility | 52 · Reduced service | $1.95 | $3.72 | $13.80 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.78 Median $1.48 Typical High $5.50 | Facility | 53 · Discontinued | $0.78 | $1.48 | $5.50 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $28.18 Median $83.18 Typical High $223.87 | Facility | 59 · Distinct service | $28.18 | $83.18 | $223.87 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $33.88 Median $144.54 Typical High $3,388.44 | Facility | 91 · Repeat lab test | $33.88 | $144.54 | $3,388.44 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $39.81 Median $77.62 Typical High $186.21 | Facility | XU · Unusual separate service | $39.81 | $77.62 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $1.58 Typical High $2.51 | Professional | 52 · Reduced service | $1.55 | $1.58 | $2.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.63 Typical High $1.00 | Professional | 53 · Discontinued | $0.62 | $0.63 | $1.00 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $3.09 Median $5.13 Typical High $13.49 | Professional | QW · Waived lab test | $3.09 | $5.13 | $13.49 |
Where Texas sits
The same service costs 9.5 times more in Minnesota 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· 16th of 51
$6.92
MN $38.02NJ $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.