How much rates vary
Facilitymedian $21 · 10th to 90th $11 to $71Professionalmedian $6 · 10th to 90th $5 to $11
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 $7.08 Median $13.80 Typical High $57.54 | Facility | None | $7.08 | $13.80 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.59 Typical High $14.45 | Professional | None | $6.76 | $7.59 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $3.98 Median $6.92 Typical High $11.48 | Professional | None | $3.98 | $6.92 | $11.48 |
BCBS Texas Setting Facility Modifier None Typical Low $12.59 Median $38.02 Typical High $75.86 | Facility | None | $12.59 | $38.02 | $75.86 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $9.12 | Professional | None | $5.01 | $6.31 | $9.12 |
Christus Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $24.55 Typical High $47.86 | Facility | None | $11.48 | $24.55 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $19.05 | Professional | None | $6.46 | $8.13 | $19.05 |
Health Smart Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Health Smart Setting Professional Modifier None Typical Low $10.23 Median $10.72 Typical High $17.38 | Professional | None | $10.23 | $10.72 | $17.38 |
Lucent Health Setting Professional Modifier None Typical Low $10.23 Median $10.72 Typical High $18.62 | Professional | None | $10.23 | $10.72 | $18.62 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $21.38 Typical High $109.65 | Facility | None | $8.71 | $21.38 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $6.76 Median $8.71 Typical High $12.02 | Professional | None | $6.76 | $8.71 | $12.02 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | None | $8.51 | $9.55 | $9.55 |
Providence Setting Facility Modifier None Typical Low $9.12 Median $16.98 Typical High $47.86 | Facility | None | $9.12 | $16.98 | $47.86 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $16.98 | Professional | None | $6.46 | $8.13 | $16.98 |
United Setting Facility Modifier None Typical Low $4.07 Median $11.48 Typical High $37.15 | Facility | None | $4.07 | $11.48 | $37.15 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $12.59 | Professional | None | $4.79 | $6.46 | $12.59 |
Wellpoint Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | None | $5.62 | $5.62 | $5.89 |
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 $8.13 Typical High $30.90 | Facility | 52 · Reduced service | $3.80 | $8.13 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.51 Median $3.31 Typical High $12.30 | Facility | 53 · Discontinued | $1.51 | $3.31 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $3.80 Typical High $6.92 | Professional | 52 · Reduced service | $3.39 | $3.80 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.51 Typical High $2.75 | Professional | 53 · Discontinued | $1.38 | $1.51 | $2.75 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4.27 Median $8.13 Typical High $30.90 | Facility | 52 · Reduced service | $4.27 | $8.13 | $30.90 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $3.31 Typical High $12.30 | Facility | 53 · Discontinued | $1.74 | $3.31 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $3.55 Typical High $5.50 | Professional | 52 · Reduced service | $3.39 | $3.55 | $5.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.41 Typical High $2.19 | Professional | 53 · Discontinued | $1.38 | $1.41 | $2.19 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $11.48 Median $12.59 Typical High $13.80 | Professional | 90 · Outside lab | $11.48 | $12.59 | $13.80 |
Where Texas sits
The same service costs 15.1 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· 27th of 51
$12.02
VT $129MD $8.51
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.