How much rates vary
Facilitymedian $17 · 10th to 90th $5 to $39Professionalmedian $5 · 10th to 90th $2 to $6
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 $4.57 Median $10.00 Typical High $38.02 | Facility | None | $4.57 | $10.00 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.37 Typical High $8.32 | Professional | None | $4.17 | $4.37 | $8.32 |
BCBS Texas Setting Facility Modifier None Typical Low $8.71 Median $24.55 Typical High $44.67 | Facility | None | $8.71 | $24.55 | $44.67 |
BCBS Texas Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $5.62 | Professional | None | $4.57 | $5.01 | $5.62 |
Christus Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $10.00 Typical High $21.88 | Facility | None | $2.88 | $10.00 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $3.47 Typical High $10.23 | Professional | None | $1.58 | $3.47 | $10.23 |
Health Smart Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Health Smart Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | None | $3.63 | $3.63 | $3.72 |
Lucent Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $7.08 Typical High $32.36 | Facility | None | $3.55 | $7.08 | $32.36 |
Moda Health Setting Professional Modifier None Typical Low $3.89 Median $4.37 Typical High $7.08 | Professional | None | $3.89 | $4.37 | $7.08 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.89 Typical High $5.89 | Professional | None | $5.25 | $5.89 | $5.89 |
Providence Setting Facility Modifier None Typical Low $2.95 Median $7.41 Typical High $21.88 | Facility | None | $2.95 | $7.41 | $21.88 |
Providence Setting Professional Modifier None Typical Low $1.55 Median $3.09 Typical High $7.08 | Professional | None | $1.55 | $3.09 | $7.08 |
United Setting Facility Modifier None Typical Low $2.51 Median $2.95 Typical High $7.08 | Facility | None | $2.51 | $2.95 | $7.08 |
United Setting Professional Modifier None Typical Low $1.95 Median $4.17 Typical High $5.62 | Professional | None | $1.95 | $4.17 | $5.62 |
Wellpoint Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
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 $2.29 Median $5.01 Typical High $19.05 | Facility | 52 · Reduced service | $2.29 | $5.01 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.91 Median $2.04 Typical High $7.59 | Facility | 53 · Discontinued | $0.91 | $2.04 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.19 Typical High $3.72 | Professional | 52 · Reduced service | $2.09 | $2.19 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.87 Typical High $1.48 | Professional | 53 · Discontinued | $0.83 | $0.87 | $1.48 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 90 · Outside lab | $2.95 | $2.95 | $2.95 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.63 Median $5.01 Typical High $19.05 | Facility | 52 · Reduced service | $2.63 | $5.01 | $19.05 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.07 Median $2.04 Typical High $7.59 | Facility | 53 · Discontinued | $1.07 | $2.04 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.19 Typical High $3.31 | Professional | 52 · Reduced service | $2.09 | $2.19 | $3.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.87 Typical High $1.32 | Professional | 53 · Discontinued | $0.83 | $0.87 | $1.32 |
Where Texas sits
The same service costs 5.4 times more in Alaska than in Kentucky. 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· 25th of 51
$6.31
AK $15.85KY $2.95
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.