How much rates vary
Facilitymedian $10 · 10th to 90th $5 to $43Professionalmedian $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 $3.16 Median $6.76 Typical High $25.70 | Facility | None | $3.16 | $6.76 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $3.16 Typical High $5.75 | Professional | None | $2.82 | $3.16 | $5.75 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $8.91 | Professional | None | $2.88 | $2.88 | $8.91 |
BCBS Texas Setting Facility Modifier None Typical Low $6.92 Median $17.38 Typical High $33.11 | Facility | None | $6.92 | $17.38 | $33.11 |
BCBS Texas Setting Professional Modifier None Typical Low $2.57 Median $4.37 Typical High $5.50 | Professional | None | $2.57 | $4.37 | $5.50 |
Christus Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $10.23 Typical High $18.20 | Facility | None | $4.57 | $10.23 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $3.09 Typical High $7.24 | Professional | None | $2.40 | $3.09 | $7.24 |
Health Smart Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Health Smart Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $7.41 | Professional | None | $4.27 | $4.57 | $7.41 |
Lucent Health Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $8.13 | Professional | None | $4.27 | $4.57 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $3.89 Median $25.70 Typical High $138.04 | Facility | None | $3.89 | $25.70 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $2.82 Median $3.72 Typical High $5.01 | Professional | None | $2.82 | $3.72 | $5.01 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $3.98 | Professional | None | $3.55 | $3.98 | $3.98 |
Providence Setting Facility Modifier None Typical Low $3.63 Median $6.31 Typical High $18.20 | Facility | None | $3.63 | $6.31 | $18.20 |
Providence Setting Professional Modifier None Typical Low $2.40 Median $3.09 Typical High $6.46 | Professional | None | $2.40 | $3.09 | $6.46 |
United Setting Facility Modifier None Typical Low $1.70 Median $2.00 Typical High $4.68 | Facility | None | $1.70 | $2.00 | $4.68 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.45 Typical High $3.63 | Professional | None | $2.00 | $2.45 | $3.63 |
Wellpoint Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.45 | Professional | None | $2.14 | $2.14 | $2.45 |
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 $1.58 Median $3.39 Typical High $12.88 | Facility | 52 · Reduced service | $1.58 | $3.39 | $12.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.63 Median $1.35 Typical High $5.13 | Facility | 53 · Discontinued | $0.63 | $1.35 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $1.55 Typical High $2.82 | Professional | 52 · Reduced service | $1.41 | $1.55 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.62 Typical High $1.12 | Professional | 53 · Discontinued | $0.56 | $0.62 | $1.12 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.78 Median $3.39 Typical High $12.88 | Facility | 52 · Reduced service | $1.78 | $3.39 | $12.88 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.72 Median $1.35 Typical High $5.13 | Facility | 53 · Discontinued | $0.72 | $1.35 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $1.48 Typical High $2.29 | Professional | 52 · Reduced service | $1.41 | $1.48 | $2.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.59 Typical High $0.91 | Professional | 53 · Discontinued | $0.58 | $0.59 | $0.91 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $4.47 Median $5.25 Typical High $5.62 | Professional | 90 · Outside lab | $4.47 | $5.25 | $5.62 |
Where Texas sits
The same service costs 3.5 times more in Kansas 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· 20th of 51
$5.01
KS $12.59MD $3.55
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.