How much rates vary
Facilitymedian $58 · 10th to 90th $28 to $174Professionalmedian $16 · 10th to 90th $5 to $31
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 $16.98 Median $26.92 Typical High $141.25 | Facility | None | $16.98 | $26.92 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $38.90 | Professional | None | $16.60 | $18.62 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $28.18 | Professional | None | $9.77 | $14.13 | $28.18 |
BCBS Texas Setting Facility Modifier None Typical Low $30.90 Median $91.20 Typical High $186.21 | Facility | None | $30.90 | $91.20 | $186.21 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $15.49 Typical High $22.39 | Professional | None | $5.01 | $15.49 | $22.39 |
Baylor Scott & White Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $199.53 | Facility | None | $28.18 | $28.18 | $199.53 |
Christus Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $60.26 Typical High $114.82 | Facility | None | $28.18 | $60.26 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $46.77 | Professional | None | $15.85 | $21.38 | $46.77 |
Health Smart Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Health Smart Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $51.29 | Professional | None | $23.44 | $34.67 | $51.29 |
Lucent Health Setting Professional Modifier None Typical Low $23.44 Median $35.48 Typical High $52.48 | Professional | None | $23.44 | $35.48 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $123.03 Typical High $239.88 | Facility | None | $21.38 | $123.03 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $16.60 Median $23.99 Typical High $34.67 | Professional | None | $16.60 | $23.99 | $34.67 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | None | $20.89 | $23.44 | $23.44 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $41.69 Typical High $114.82 | Facility | None | $22.39 | $41.69 | $114.82 |
Providence Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $41.69 | Professional | None | $15.85 | $20.42 | $41.69 |
United Setting Facility Modifier None Typical Low $10.00 Median $28.18 Typical High $89.13 | Facility | None | $10.00 | $28.18 | $89.13 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $25.12 | Professional | None | $11.75 | $15.85 | $25.12 |
Wellpoint Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | None | $13.80 | $13.80 | $14.45 |
9 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 $9.33 Median $19.95 Typical High $75.86 | Facility | 52 · Reduced service | $9.33 | $19.95 | $75.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.72 Median $7.94 Typical High $30.20 | Facility | 53 · Discontinued | $3.72 | $7.94 | $30.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $9.12 Typical High $16.60 | Professional | 52 · Reduced service | $8.32 | $9.12 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.72 Typical High $6.76 | Professional | 53 · Discontinued | $3.39 | $3.72 | $6.76 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $10.47 Median $19.95 Typical High $75.86 | Facility | 52 · Reduced service | $10.47 | $19.95 | $75.86 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $4.27 Median $8.13 Typical High $30.20 | Facility | 53 · Discontinued | $4.27 | $8.13 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $8.71 Typical High $13.49 | Professional | 52 · Reduced service | $8.32 | $8.71 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.47 Typical High $5.37 | Professional | 53 · Discontinued | $3.39 | $3.47 | $5.37 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $19.95 Median $25.70 Typical High $28.18 | Professional | 90 · Outside lab | $19.95 | $25.70 | $28.18 |
Where Texas sits
The same service costs 7.8 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· 28th of 51
$28.18
VT $145AL $18.62
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.