How much rates vary
Facilitymedian $27 · 10th to 90th $7 to $186Professionalmedian $5 · 10th to 90th $4 to $8
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 $4.07 Median $5.13 Typical High $33.88 | Facility | None | $4.07 | $5.13 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $4.79 Typical High $9.12 | Professional | None | $3.98 | $4.79 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $3.39 Typical High $6.76 | Professional | None | $2.34 | $3.39 | $6.76 |
BCBS Texas Setting Facility Modifier None Typical Low $7.41 Median $21.88 Typical High $44.67 | Facility | None | $7.41 | $21.88 | $44.67 |
BCBS Texas Setting Professional Modifier None Typical Low $3.72 Median $5.01 Typical High $5.50 | Professional | None | $3.72 | $5.01 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $4.68 Median $6.76 Typical High $9.12 | Facility | None | $4.68 | $6.76 | $9.12 |
Christus Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $14.45 Typical High $27.54 | Facility | None | $6.76 | $14.45 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $5.50 Typical High $12.02 | Professional | None | $3.89 | $5.50 | $12.02 |
Health Smart Setting Facility Modifier None Typical Low $10.23 Median $12.59 Typical High $20.89 | Facility | None | $10.23 | $12.59 | $20.89 |
Health Smart Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $12.59 | Professional | None | $5.75 | $8.32 | $12.59 |
Lucent Health Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $12.59 | Professional | None | $5.75 | $8.32 | $12.59 |
Moda Health Setting Facility Modifier None Typical Low $8.51 Median $97.72 Typical High $316.23 | Facility | None | $8.51 | $97.72 | $316.23 |
Moda Health Setting Professional Modifier None Typical Low $3.98 Median $5.75 Typical High $8.13 | Professional | None | $3.98 | $5.75 | $8.13 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $5.62 | Professional | None | $5.01 | $5.62 | $5.62 |
Providence Setting Facility Modifier None Typical Low $5.37 Median $10.00 Typical High $26.92 | Facility | None | $5.37 | $10.00 | $26.92 |
Providence Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $11.48 | Professional | None | $3.89 | $5.37 | $11.48 |
United Setting Facility Modifier None Typical Low $2.24 Median $2.82 Typical High $20.89 | Facility | None | $2.24 | $2.82 | $20.89 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $6.31 | Professional | None | $2.82 | $3.80 | $6.31 |
Wellpoint Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | None | $3.31 | $3.31 | $3.47 |
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 $2.24 Median $4.79 Typical High $18.20 | Facility | 52 · Reduced service | $2.24 | $4.79 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.89 Median $1.95 Typical High $7.24 | Facility | 53 · Discontinued | $0.89 | $1.95 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.19 Typical High $3.98 | Professional | 52 · Reduced service | $2.00 | $2.19 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.87 Typical High $1.62 | Professional | 53 · Discontinued | $0.79 | $0.87 | $1.62 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.51 Median $4.79 Typical High $18.20 | Facility | 52 · Reduced service | $2.51 | $4.79 | $18.20 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.00 Median $1.95 Typical High $7.24 | Facility | 53 · Discontinued | $1.00 | $1.95 | $7.24 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $29.51 Median $131.83 Typical High $138.04 | Facility | 91 · Repeat lab test | $29.51 | $131.83 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.09 Typical High $3.24 | Professional | 52 · Reduced service | $2.00 | $2.09 | $3.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.83 Typical High $1.29 | Professional | 53 · Discontinued | $0.79 | $0.83 | $1.29 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $4.79 Median $7.41 Typical High $8.13 | Professional | 90 · Outside lab | $4.79 | $7.41 | $8.13 |
Where Texas sits
The same service costs 10.0 times more in Minnesota 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· 26th of 51
$7.41
MN $51.29MD $5.13
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.