How much rates vary
Facilitymedian $52 · 10th to 90th $26 to $166Professionalmedian $15 · 10th to 90th $5 to $28
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 $15.85 Median $20.89 Typical High $131.83 | Facility | None | $15.85 | $20.89 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $17.78 Typical High $35.48 | Professional | None | $15.49 | $17.78 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $9.12 Median $12.88 Typical High $25.70 | Professional | None | $9.12 | $12.88 | $25.70 |
BCBS Texas Setting Facility Modifier None Typical Low $28.18 Median $85.11 Typical High $169.82 | Facility | None | $28.18 | $85.11 | $169.82 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $14.13 Typical High $20.42 | Professional | None | $5.01 | $14.13 | $20.42 |
Baylor Scott & White Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $123.03 | Facility | None | $25.70 | $25.70 | $123.03 |
Christus Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $56.23 Typical High $107.15 | Facility | None | $25.70 | $56.23 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $46.77 | Professional | None | $14.45 | $20.89 | $46.77 |
Health Smart Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Health Smart Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $47.86 | Professional | None | $21.88 | $32.36 | $47.86 |
Lucent Health Setting Professional Modifier None Typical Low $21.88 Median $32.36 Typical High $48.98 | Professional | None | $21.88 | $32.36 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $19.50 Median $97.72 Typical High $208.93 | Facility | None | $19.50 | $97.72 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $30.90 | Professional | None | $15.49 | $21.38 | $30.90 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $21.88 | Professional | None | $19.50 | $21.88 | $21.88 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $38.02 Typical High $107.15 | Facility | None | $20.42 | $38.02 | $107.15 |
Providence Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $44.67 | Professional | None | $14.45 | $20.42 | $44.67 |
United Setting Facility Modifier None Typical Low $9.33 Median $25.70 Typical High $104.71 | Facility | None | $9.33 | $25.70 | $104.71 |
United Setting Professional Modifier None Typical Low $10.96 Median $14.79 Typical High $21.38 | Professional | None | $10.96 | $14.79 | $21.38 |
Wellpoint Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | None | $12.88 | $12.88 | $13.49 |
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 $8.71 Median $18.62 Typical High $69.18 | Facility | 52 · Reduced service | $8.71 | $18.62 | $69.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $7.41 Typical High $28.18 | Facility | 53 · Discontinued | $3.47 | $7.41 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $15.49 | Professional | 52 · Reduced service | $7.76 | $8.51 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.39 Typical High $6.17 | Professional | 53 · Discontinued | $3.09 | $3.39 | $6.17 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $9.77 Median $18.62 Typical High $69.18 | Facility | 52 · Reduced service | $9.77 | $18.62 | $69.18 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $3.89 Median $7.41 Typical High $28.18 | Facility | 53 · Discontinued | $3.89 | $7.41 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $7.94 Typical High $12.59 | Professional | 52 · Reduced service | $7.76 | $7.94 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.24 Typical High $5.01 | Professional | 53 · Discontinued | $3.09 | $3.24 | $5.01 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $18.20 Median $22.39 Typical High $30.90 | Professional | 90 · Outside lab | $18.20 | $22.39 | $30.90 |
Where Texas sits
The same service costs 7.4 times more in Vermont than in Alabama. 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
$25.70
VT $138AL $18.62
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.