How much rates vary
Facilitymedian $31 · 10th to 90th $8 to $224Professionalmedian $5 · 10th to 90th $4 to $9
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 $4.47 Median $6.92 Typical High $38.02 | Facility | None | $4.47 | $6.92 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $10.23 | Professional | None | $4.47 | $5.01 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $7.59 | Professional | None | $2.63 | $3.80 | $7.59 |
BCBS Texas Setting Facility Modifier None Typical Low $8.91 Median $26.30 Typical High $50.12 | Facility | None | $8.91 | $26.30 | $50.12 |
BCBS Texas Setting Professional Modifier None Typical Low $4.17 Median $5.01 Typical High $6.03 | Professional | None | $4.17 | $5.01 | $6.03 |
Baylor Scott & White Setting Facility Modifier None Typical Low $12.30 Median $38.02 Typical High $165.96 | Facility | None | $12.30 | $38.02 | $165.96 |
Christus Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $16.22 Typical High $31.62 | Facility | None | $7.59 | $16.22 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $8.32 Typical High $13.80 | Professional | None | $4.68 | $8.32 | $13.80 |
Health Smart Setting Facility Modifier None Typical Low $11.48 Median $14.13 Typical High $35.48 | Facility | None | $11.48 | $14.13 | $35.48 |
Health Smart Setting Professional Modifier None Typical Low $6.31 Median $9.77 Typical High $15.49 | Professional | None | $6.31 | $9.77 | $15.49 |
Lucent Health Setting Professional Modifier None Typical Low $6.31 Median $9.55 Typical High $15.49 | Professional | None | $6.31 | $9.55 | $15.49 |
Moda Health Setting Facility Modifier None Typical Low $9.33 Median $134.90 Typical High $346.74 | Facility | None | $9.33 | $134.90 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $4.47 Median $6.03 Typical High $9.12 | Professional | None | $4.47 | $6.03 | $9.12 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | None | $5.62 | $6.31 | $6.31 |
Providence Setting Facility Modifier None Typical Low $6.03 Median $11.22 Typical High $31.62 | Facility | None | $6.03 | $11.22 | $31.62 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $7.59 Typical High $13.18 | Professional | None | $4.68 | $7.59 | $13.18 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $7.59 | Facility | None | $2.45 | $2.45 | $7.59 |
United Setting Professional Modifier None Typical Low $3.16 Median $4.27 Typical High $6.17 | Professional | None | $3.16 | $4.27 | $6.17 |
Wellpoint Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
10 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 $2.51 Median $5.37 Typical High $20.42 | Facility | 52 · Reduced service | $2.51 | $5.37 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.00 Median $2.14 Typical High $8.13 | Facility | 53 · Discontinued | $1.00 | $2.14 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.45 Typical High $4.47 | Professional | 52 · Reduced service | $2.24 | $2.45 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $1.00 Typical High $1.82 | Professional | 53 · Discontinued | $0.89 | $1.00 | $1.82 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.82 Median $5.37 Typical High $20.42 | Facility | 52 · Reduced service | $2.82 | $5.37 | $20.42 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.15 Median $2.14 Typical High $8.13 | Facility | 53 · Discontinued | $1.15 | $2.14 | $8.13 |
Moda Health Setting Facility Modifier QW · Waived lab test Typical Low $38.90 Median $104.71 Typical High $151.36 | Facility | QW · Waived lab test | $38.90 | $104.71 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.34 Typical High $3.63 | Professional | 52 · Reduced service | $2.24 | $2.34 | $3.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.93 Typical High $1.45 | Professional | 53 · Discontinued | $0.89 | $0.93 | $1.45 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $4.47 Median $7.59 Typical High $9.33 | Professional | QW · Waived lab test | $4.47 | $7.59 | $9.33 |
Where Texas sits
The same service costs 21.4 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· 11th of 51
$13.49
VT $120MD $5.62
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.