How much rates vary
Facilitymedian $55 · 10th to 90th $17 to $263Professionalmedian $10 · 10th to 90th $5 to $20
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 $10.47 Median $12.88 Typical High $85.11 | Facility | None | $10.47 | $12.88 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $23.44 | Professional | None | $10.00 | $11.75 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $14.13 | Professional | None | $5.89 | $8.32 | $14.13 |
BCBS Texas Setting Facility Modifier None Typical Low $18.62 Median $56.23 Typical High $109.65 | Facility | None | $18.62 | $56.23 | $109.65 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $9.33 Typical High $13.49 | Professional | None | $5.01 | $9.33 | $13.49 |
Baylor Scott & White Setting Facility Modifier None Typical Low $15.85 Median $16.98 Typical High $22.91 | Facility | None | $15.85 | $16.98 | $22.91 |
Christus Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $36.31 Typical High $69.18 | Facility | None | $16.98 | $36.31 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $18.62 Typical High $30.20 | Professional | None | $10.47 | $18.62 | $30.20 |
Health Smart Setting Facility Modifier None Typical Low $25.70 Median $30.90 Typical High $64.57 | Facility | None | $25.70 | $30.90 | $64.57 |
Health Smart Setting Professional Modifier None Typical Low $14.45 Median $21.38 Typical High $33.88 | Professional | None | $14.45 | $21.38 | $33.88 |
Lucent Health Setting Professional Modifier None Typical Low $14.45 Median $21.38 Typical High $33.88 | Professional | None | $14.45 | $21.38 | $33.88 |
Moda Health Setting Facility Modifier None Typical Low $16.98 Median $134.90 Typical High $363.08 | Facility | None | $16.98 | $134.90 | $363.08 |
Moda Health Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $89.13 | Professional | None | $10.00 | $14.13 | $89.13 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | None | $12.59 | $14.13 | $14.13 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $24.55 Typical High $69.18 | Facility | None | $13.49 | $24.55 | $69.18 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $16.98 Typical High $28.84 | Professional | None | $10.47 | $16.98 | $28.84 |
United Setting Facility Modifier None Typical Low $5.89 Median $7.08 Typical High $60.26 | Facility | None | $5.89 | $7.08 | $60.26 |
United Setting Professional Modifier None Typical Low $7.08 Median $9.55 Typical High $13.80 | Professional | None | $7.08 | $9.55 | $13.80 |
Wellpoint Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
12 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 $5.62 Median $12.02 Typical High $45.71 | Facility | 52 · Reduced service | $5.62 | $12.02 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $4.79 Typical High $18.20 | Facility | 53 · Discontinued | $2.24 | $4.79 | $18.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.50 Typical High $10.00 | Professional | 52 · Reduced service | $5.01 | $5.50 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.24 Typical High $4.07 | Professional | 53 · Discontinued | $2.04 | $2.24 | $4.07 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $7.08 Median $8.32 Typical High $16.98 | Professional | QW · Waived lab test | $7.08 | $8.32 | $16.98 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $6.31 Median $12.02 Typical High $45.71 | Facility | 52 · Reduced service | $6.31 | $12.02 | $45.71 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.51 Median $4.79 Typical High $18.20 | Facility | 53 · Discontinued | $2.51 | $4.79 | $18.20 |
Moda Health Setting Facility Modifier QW · Waived lab test Typical Low $19.50 Median $141.25 Typical High $275.42 | Facility | QW · Waived lab test | $19.50 | $141.25 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.25 Typical High $8.13 | Professional | 52 · Reduced service | $5.01 | $5.25 | $8.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.09 Typical High $3.24 | Professional | 53 · Discontinued | $2.04 | $2.09 | $3.24 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $15.14 Median $20.89 Typical High $39.81 | Professional | 90 · Outside lab | $15.14 | $20.89 | $39.81 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $10.00 Median $13.49 Typical High $30.20 | Professional | QW · Waived lab test | $10.00 | $13.49 | $30.20 |
Where Texas sits
The same service costs 7.8 times more in Vermont 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· 33rd of 51
$16.98
VT $105MD $13.49
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.