How much rates vary
Facilitymedian $38 · 10th to 90th $19 to $129Professionalmedian $10 · 10th to 90th $5 to $20
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 $11.22 Median $16.98 Typical High $95.50 | Facility | None | $11.22 | $16.98 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $25.70 | Professional | None | $11.22 | $12.88 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $9.33 Typical High $18.62 | Professional | None | $6.46 | $9.33 | $18.62 |
BCBS Texas Setting Facility Modifier None Typical Low $20.42 Median $61.66 Typical High $123.03 | Facility | None | $20.42 | $61.66 | $123.03 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $10.23 Typical High $13.80 | Professional | None | $5.01 | $10.23 | $13.80 |
Baylor Scott & White Setting Facility Modifier None Typical Low $16.98 Median $25.12 Typical High $134.90 | Facility | None | $16.98 | $25.12 | $134.90 |
Christus Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $40.74 Typical High $75.86 | Facility | None | $18.62 | $40.74 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $20.89 Typical High $33.88 | Professional | None | $11.75 | $20.89 | $33.88 |
Health Smart Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Health Smart Setting Professional Modifier None Typical Low $16.60 Median $19.95 Typical High $30.90 | Professional | None | $16.60 | $19.95 | $30.90 |
Lucent Health Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $30.90 | Professional | None | $16.60 | $17.78 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $83.18 Typical High $199.53 | Facility | None | $14.13 | $83.18 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $15.85 Typical High $22.39 | Professional | None | $11.22 | $15.85 | $22.39 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | None | $13.80 | $15.49 | $15.49 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $27.54 Typical High $75.86 | Facility | None | $14.79 | $27.54 | $75.86 |
Providence Setting Professional Modifier None Typical Low $11.75 Median $18.62 Typical High $32.36 | Professional | None | $11.75 | $18.62 | $32.36 |
United Setting Facility Modifier None Typical Low $6.76 Median $18.62 Typical High $89.13 | Facility | None | $6.76 | $18.62 | $89.13 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.72 Typical High $15.49 | Professional | None | $7.76 | $10.72 | $15.49 |
Wellpoint Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
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 $6.17 Median $13.49 Typical High $50.12 | Facility | 52 · Reduced service | $6.17 | $13.49 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.51 Median $5.37 Typical High $19.95 | Facility | 53 · Discontinued | $2.51 | $5.37 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $6.17 Typical High $11.22 | Professional | 52 · Reduced service | $5.62 | $6.17 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.45 Typical High $4.47 | Professional | 53 · Discontinued | $2.24 | $2.45 | $4.47 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $7.08 Median $13.49 Typical High $50.12 | Facility | 52 · Reduced service | $7.08 | $13.49 | $50.12 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.82 Median $5.37 Typical High $19.95 | Facility | 53 · Discontinued | $2.82 | $5.37 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.75 Typical High $8.91 | Professional | 52 · Reduced service | $5.62 | $5.75 | $8.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.29 Typical High $3.63 | Professional | 53 · Discontinued | $2.24 | $2.29 | $3.63 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $11.22 Median $15.14 Typical High $22.91 | Professional | QW · Waived lab test | $11.22 | $15.14 | $22.91 |
Where Texas sits
The same service costs 6.8 times more in Vermont than in Maryland. 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· 27th of 51
$19.50
VT $95.50MD $14.13
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.