How much rates vary
Facilitymedian $30 · 10th to 90th $10 to $62Professionalmedian $7 · 10th to 90th $5 to $10
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 $7.59 Median $16.60 Typical High $61.66 | Facility | None | $7.59 | $16.60 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.08 Typical High $11.22 | Professional | None | $6.92 | $7.08 | $11.22 |
BCBS Texas Setting Facility Modifier None Typical Low $14.13 Median $40.74 Typical High $66.07 | Facility | None | $14.13 | $40.74 | $66.07 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $7.76 | Professional | None | $5.01 | $6.31 | $7.76 |
Christus Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $25.12 Typical High $47.86 | Facility | None | $11.48 | $25.12 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $19.50 | Professional | None | $6.46 | $8.32 | $19.50 |
Health Smart Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Health Smart Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | None | $17.38 | $17.38 | $17.78 |
Lucent Health Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Moda Health Setting Facility Modifier None Typical Low $6.92 Median $11.48 Typical High $41.69 | Facility | None | $6.92 | $11.48 | $41.69 |
Moda Health Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $11.48 | Professional | None | $6.92 | $7.24 | $11.48 |
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 $8.32 Median $16.98 Typical High $47.86 | Facility | None | $8.32 | $16.98 | $47.86 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $17.38 | Professional | None | $6.46 | $8.32 | $17.38 |
United Setting Facility Modifier None Typical Low $4.17 Median $4.79 Typical High $11.48 | Facility | None | $4.17 | $4.79 | $11.48 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.61 Typical High $9.12 | Professional | None | $4.79 | $6.61 | $9.12 |
Wellpoint Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | None | $5.75 | $5.75 | $6.03 |
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 $3.80 Median $8.32 Typical High $30.90 | Facility | 52 · Reduced service | $3.80 | $8.32 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.51 Median $3.31 Typical High $12.59 | Facility | 53 · Discontinued | $1.51 | $3.31 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.63 Typical High $6.92 | Professional | 52 · Reduced service | $3.47 | $3.63 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.45 Typical High $2.75 | Professional | 53 · Discontinued | $1.38 | $1.45 | $2.75 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 90 · Outside lab | $7.94 | $7.94 | $7.94 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4.37 Median $8.32 Typical High $30.90 | Facility | 52 · Reduced service | $4.37 | $8.32 | $30.90 |
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 Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.55 Typical High $5.37 | Professional | 52 · Reduced service | $3.47 | $3.55 | $5.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.45 Typical High $2.19 | Professional | 53 · Discontinued | $1.38 | $1.45 | $2.19 |
Where Texas sits
The same service costs 4.8 times more in Kansas than in Nebraska. 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· 33rd of 51
$10.96
KS $36.31NE $7.59
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.