How much rates vary
Facilitymedian $37 · 10th to 90th $17 to $132Professionalmedian $10 · 10th to 90th $5 to $17
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 $10.96 Median $20.89 Typical High $87.10 | Facility | None | $10.96 | $20.89 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $20.89 | Professional | None | $10.23 | $11.48 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $17.38 | Professional | None | $8.71 | $8.71 | $17.38 |
BCBS Texas Setting Facility Modifier None Typical Low $20.42 Median $60.26 Typical High $114.82 | Facility | None | $20.42 | $60.26 | $114.82 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $9.55 Typical High $13.80 | Professional | None | $5.01 | $9.55 | $13.80 |
Baylor Scott & White Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $93.33 | Facility | None | $17.38 | $17.38 | $93.33 |
Christus Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $36.31 Typical High $54.95 | Facility | None | $14.13 | $36.31 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $9.33 Typical High $26.30 | Professional | None | $8.32 | $9.33 | $26.30 |
Health Smart Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Health Smart Setting Professional Modifier None Typical Low $15.49 Median $16.22 Typical High $25.70 | Professional | None | $15.49 | $16.22 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $15.49 Median $16.22 Typical High $28.18 | Professional | None | $15.49 | $16.22 | $28.18 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $70.79 Typical High $295.12 | Facility | None | $14.13 | $70.79 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $10.47 Median $12.30 Typical High $17.38 | Professional | None | $10.47 | $12.30 | $17.38 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | None | $12.88 | $14.45 | $14.45 |
Providence Setting Facility Modifier None Typical Low $12.59 Median $20.89 Typical High $53.70 | Facility | None | $12.59 | $20.89 | $53.70 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $9.33 Typical High $21.88 | Professional | None | $8.13 | $9.33 | $21.88 |
United Setting Facility Modifier None Typical Low $6.17 Median $7.24 Typical High $17.38 | Facility | None | $6.17 | $7.24 | $17.38 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $11.22 | Professional | None | $7.24 | $7.59 | $11.22 |
Wellpoint Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
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 $5.75 Median $12.30 Typical High $46.77 | Facility | 52 · Reduced service | $5.75 | $12.30 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.29 Median $5.01 Typical High $18.62 | Facility | 53 · Discontinued | $2.29 | $5.01 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $5.75 Typical High $10.47 | Professional | 52 · Reduced service | $5.13 | $5.75 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.29 Typical High $4.17 | Professional | 53 · Discontinued | $2.04 | $2.29 | $4.17 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $6.46 Median $12.30 Typical High $46.77 | Facility | 52 · Reduced service | $6.46 | $12.30 | $46.77 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.63 Median $5.01 Typical High $18.62 | Facility | 53 · Discontinued | $2.63 | $5.01 | $18.62 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $57.54 Median $57.54 Typical High $354.81 | Facility | 91 · Repeat lab test | $57.54 | $57.54 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $5.37 Typical High $8.32 | Professional | 52 · Reduced service | $5.13 | $5.37 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.14 Typical High $3.39 | Professional | 53 · Discontinued | $2.09 | $2.14 | $3.39 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $11.75 Median $17.38 Typical High $20.89 | Professional | 90 · Outside lab | $11.75 | $17.38 | $20.89 |
Where Texas sits
The same service costs 20.4 times more in Vermont than in Kentucky. 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
$21.38
VT $229KY $11.22
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.