How much rates vary
Facilitymedian $40 · 10th to 90th $11 to $170Professionalmedian $6 · 10th to 90th $5 to $12
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 $7.08 Median $9.77 Typical High $58.88 | Facility | None | $7.08 | $9.77 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $14.13 | Professional | None | $6.92 | $7.59 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $7.08 Typical High $9.77 | Professional | None | $5.50 | $7.08 | $9.77 |
BCBS Texas Setting Facility Modifier None Typical Low $12.88 Median $37.15 Typical High $75.86 | Facility | None | $12.88 | $37.15 | $75.86 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $8.51 | Professional | None | $5.01 | $6.31 | $8.51 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $25.12 Typical High $44.67 | Facility | None | $11.22 | $25.12 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $8.13 Typical High $17.78 | Professional | None | $6.03 | $8.13 | $17.78 |
Health Smart Setting Facility Modifier None Typical Low $16.60 Median $19.50 Typical High $57.54 | Facility | None | $16.60 | $19.50 | $57.54 |
Health Smart Setting Professional Modifier None Typical Low $10.00 Median $16.22 Typical High $38.02 | Professional | None | $10.00 | $16.22 | $38.02 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $16.98 Typical High $38.02 | Professional | None | $10.00 | $16.98 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $11.48 Median $114.82 Typical High $338.84 | Facility | None | $11.48 | $114.82 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $13.80 | Professional | None | $6.92 | $8.13 | $13.80 |
Molina Setting Professional Modifier None Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | None | $8.71 | $9.77 | $9.77 |
Providence Setting Facility Modifier None Typical Low $8.91 Median $15.85 Typical High $44.67 | Facility | None | $8.91 | $15.85 | $44.67 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $7.76 Typical High $15.49 | Professional | None | $6.03 | $7.76 | $15.49 |
United Setting Facility Modifier None Typical Low $4.17 Median $11.48 Typical High $44.67 | Facility | None | $4.17 | $11.48 | $44.67 |
United Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $9.12 | Professional | None | $4.90 | $6.31 | $9.12 |
Wellpoint Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
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 $3.89 Median $8.32 Typical High $31.62 | Facility | 52 · Reduced service | $3.89 | $8.32 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.55 Median $3.31 Typical High $12.59 | Facility | 53 · Discontinued | $1.55 | $3.31 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.80 Typical High $6.92 | Professional | 52 · Reduced service | $3.47 | $3.80 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.51 Typical High $2.75 | Professional | 53 · Discontinued | $1.38 | $1.51 | $2.75 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4.37 Median $8.32 Typical High $31.62 | Facility | 52 · Reduced service | $4.37 | $8.32 | $31.62 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $3.31 Typical High $12.59 | Facility | 53 · Discontinued | $1.74 | $3.31 | $12.59 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $47.86 Median $158.49 Typical High $724.44 | Facility | 91 · Repeat lab test | $47.86 | $158.49 | $724.44 |
Moda Health Setting Facility Modifier QW · Waived lab test Typical Low $54.95 Median $123.03 Typical High $467.74 | Facility | QW · Waived lab test | $54.95 | $123.03 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.63 Typical High $5.62 | Professional | 52 · Reduced service | $3.47 | $3.63 | $5.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.45 Typical High $2.24 | Professional | 53 · Discontinued | $1.38 | $1.45 | $2.24 |
Where Texas sits
The same service costs 13.2 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· 12th of 51
$19.50
VT $115MD $8.71
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.