How much rates vary
Facilitymedian $8 · 10th to 90th $4 to $23Professionalmedian $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 $2.40 Median $4.90 Typical High $19.50 | Facility | None | $2.40 | $4.90 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $5.01 | Professional | None | $2.14 | $2.34 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.51 | Professional | None | $1.78 | $1.78 | $2.51 |
BCBS Texas Setting Facility Modifier None Typical Low $5.01 Median $13.18 Typical High $25.12 | Facility | None | $5.01 | $13.18 | $25.12 |
BCBS Texas Setting Professional Modifier None Typical Low $1.95 Median $3.55 Typical High $5.50 | Professional | None | $1.95 | $3.55 | $5.50 |
Baylor Scott & White Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $5.01 | Professional | None | $2.69 | $3.24 | $5.01 |
Christus Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $7.76 Typical High $15.14 | Facility | None | $3.63 | $7.76 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.75 Typical High $6.03 | Professional | None | $2.04 | $2.75 | $6.03 |
Health Smart Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Health Smart Setting Professional Modifier None Typical Low $3.16 Median $3.39 Typical High $5.50 | Professional | None | $3.16 | $3.39 | $5.50 |
Moda Health Setting Facility Modifier None Typical Low $3.02 Median $15.49 Typical High $46.77 | Facility | None | $3.02 | $15.49 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $4.90 | Professional | None | $2.14 | $2.69 | $4.90 |
Molina Setting Professional Modifier None Typical Low $2.69 Median $3.02 Typical High $3.02 | Professional | None | $2.69 | $3.02 | $3.02 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $5.25 Typical High $15.14 | Facility | None | $2.88 | $5.25 | $15.14 |
Providence Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $5.37 | Professional | None | $2.04 | $2.57 | $5.37 |
United Setting Facility Modifier None Typical Low $1.29 Median $1.51 Typical High $3.55 | Facility | None | $1.29 | $1.51 | $3.55 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.95 Typical High $3.55 | Professional | None | $2.14 | $2.95 | $3.55 |
Wellpoint Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
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 $1.20 Median $2.57 Typical High $9.77 | Facility | 52 · Reduced service | $1.20 | $2.57 | $9.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.48 Median $1.02 Typical High $3.89 | Facility | 53 · Discontinued | $0.48 | $1.02 | $3.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.17 Typical High $2.14 | Professional | 52 · Reduced service | $1.07 | $1.17 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.47 Typical High $0.85 | Professional | 53 · Discontinued | $0.43 | $0.47 | $0.85 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.35 Median $2.57 Typical High $9.77 | Facility | 52 · Reduced service | $1.35 | $2.57 | $9.77 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.54 Median $1.02 Typical High $3.89 | Facility | 53 · Discontinued | $0.54 | $1.02 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.12 Typical High $1.74 | Professional | 52 · Reduced service | $1.07 | $1.12 | $1.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.44 Typical High $0.69 | Professional | 53 · Discontinued | $0.43 | $0.44 | $0.69 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $2.14 Median $3.39 Typical High $4.47 | Professional | QW · Waived lab test | $2.14 | $3.39 | $4.47 |
Where Texas sits
The same service costs 3.5 times more in Kansas than in Tennessee. 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· 18th of 51
$4.17
KS $10.00TN $2.82
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.