How much rates vary
Facilitymedian $7 · 10th to 90th $3 to $48Professionalmedian $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 $2.45 Median $4.68 Typical High $19.95 | Facility | None | $2.45 | $4.68 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.69 Typical High $5.50 | Professional | None | $2.34 | $2.69 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $1.95 Typical High $3.80 | Professional | None | $1.74 | $1.95 | $3.80 |
BCBS Texas Setting Facility Modifier None Typical Low $2.51 Median $7.59 Typical High $22.91 | Facility | None | $2.51 | $7.59 | $22.91 |
BCBS Texas Setting Professional Modifier None Typical Low $2.51 Median $5.01 Typical High $5.50 | Professional | None | $2.51 | $5.01 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $5.37 | Facility | None | $3.89 | $3.89 | $5.37 |
Christus Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $8.51 Typical High $16.22 | Facility | None | $3.98 | $8.51 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $4.37 Typical High $6.92 | Professional | None | $2.45 | $4.37 | $6.92 |
Health Smart Setting Facility Modifier None Typical Low $6.03 Median $7.08 Typical High $7.08 | Facility | None | $6.03 | $7.08 | $7.08 |
Health Smart Setting Professional Modifier None Typical Low $3.31 Median $4.90 Typical High $7.41 | Professional | None | $3.31 | $4.90 | $7.41 |
Lucent Health Setting Professional Modifier None Typical Low $3.31 Median $4.90 Typical High $7.59 | Professional | None | $3.31 | $4.90 | $7.59 |
Moda Health Setting Facility Modifier None Typical Low $3.89 Median $33.11 Typical High $95.50 | Facility | None | $3.89 | $33.11 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $2.34 Median $3.39 Typical High $5.37 | Professional | None | $2.34 | $3.39 | $5.37 |
Molina Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Providence Setting Facility Modifier None Typical Low $3.16 Median $5.75 Typical High $16.22 | Facility | None | $3.16 | $5.75 | $16.22 |
Providence Setting Professional Modifier None Typical Low $2.45 Median $3.89 Typical High $6.92 | Professional | None | $2.45 | $3.89 | $6.92 |
United Setting Facility Modifier None Typical Low $1.41 Median $3.89 Typical High $10.47 | Facility | None | $1.41 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.16 Typical High $3.89 | Professional | None | $2.34 | $3.16 | $3.89 |
Wellpoint Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
13 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 $1.32 Median $2.82 Typical High $10.72 | Facility | 52 · Reduced service | $1.32 | $2.82 | $10.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.52 Median $1.12 Typical High $4.27 | Facility | 53 · Discontinued | $0.52 | $1.12 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.29 Typical High $2.34 | Professional | 52 · Reduced service | $1.17 | $1.29 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.52 Typical High $0.93 | Professional | 53 · Discontinued | $0.47 | $0.52 | $0.93 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.66 Median $1.95 Typical High $3.31 | Professional | QW · Waived lab test | $1.66 | $1.95 | $3.31 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.48 Median $2.82 Typical High $10.72 | Facility | 52 · Reduced service | $1.48 | $2.82 | $10.72 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.60 Median $1.12 Typical High $4.27 | Facility | 53 · Discontinued | $0.60 | $1.12 | $4.27 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $13.18 Median $33.11 Typical High $75.86 | Facility | 59 · Distinct service | $13.18 | $33.11 | $75.86 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $16.98 Median $39.81 Typical High $89.13 | Facility | 91 · Repeat lab test | $16.98 | $39.81 | $89.13 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $13.18 Median $13.18 Typical High $169.82 | Facility | XU · Unusual separate service | $13.18 | $13.18 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.23 Typical High $1.91 | Professional | 52 · Reduced service | $1.17 | $1.23 | $1.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.49 Typical High $0.76 | Professional | 53 · Discontinued | $0.47 | $0.49 | $0.76 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $2.34 Median $3.89 Typical High $4.90 | Professional | QW · Waived lab test | $2.34 | $3.89 | $4.90 |
Where Texas sits
The same service costs 12.6 times more in Vermont than in Washington, DC. 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· 17th of 51
$5.01
VT $39.81DC $3.16
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.