How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $49Professionalmedian $2 · 10th to 90th $1 to $5
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 $1.45 Median $2.82 Typical High $12.02 | Facility | None | $1.45 | $2.82 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.58 Typical High $3.31 | Professional | None | $1.41 | $1.58 | $3.31 |
Ambetter Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $2.00 | Professional | None | $1.12 | $1.23 | $2.00 |
BCBS Texas Setting Facility Modifier None Typical Low $1.55 Median $5.01 Typical High $14.45 | Facility | None | $1.55 | $5.01 | $14.45 |
BCBS Texas Setting Professional Modifier None Typical Low $1.55 Median $4.37 Typical High $5.50 | Professional | None | $1.55 | $4.37 | $5.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Christus Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Facility | None | $2.34 | $2.34 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $5.13 Typical High $10.00 | Facility | None | $2.40 | $5.13 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $2.34 Typical High $3.80 | Professional | None | $1.41 | $2.34 | $3.80 |
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 $1.95 Median $3.02 Typical High $4.57 | Professional | None | $1.95 | $3.02 | $4.57 |
Lucent Health Setting Professional Modifier None Typical Low $1.95 Median $2.88 Typical High $4.57 | Professional | None | $1.95 | $2.88 | $4.57 |
Moda Health Setting Facility Modifier None Typical Low $2.34 Median $36.31 Typical High $72.44 | Facility | None | $2.34 | $36.31 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $1.41 Median $2.09 Typical High $77.62 | Professional | None | $1.41 | $2.09 | $77.62 |
Molina Setting Professional Modifier None Typical Low $1.78 Median $2.00 Typical High $2.00 | Professional | None | $1.78 | $2.00 | $2.00 |
Providence Setting Facility Modifier None Typical Low $1.95 Median $3.47 Typical High $10.00 | Facility | None | $1.95 | $3.47 | $10.00 |
Providence Setting Professional Modifier None Typical Low $1.41 Median $2.04 Typical High $3.55 | Professional | None | $1.41 | $2.04 | $3.55 |
United Setting Facility Modifier None Typical Low $0.85 Median $2.34 Typical High $7.59 | Facility | None | $0.85 | $2.34 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $1.95 Typical High $2.34 | Professional | None | $1.41 | $1.95 | $2.34 |
Wellpoint Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
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 $0.79 Median $1.70 Typical High $6.46 | Facility | 52 · Reduced service | $0.79 | $1.70 | $6.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.32 Median $0.68 Typical High $2.57 | Facility | 53 · Discontinued | $0.32 | $0.68 | $2.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $0.78 Typical High $1.41 | Professional | 52 · Reduced service | $0.71 | $0.78 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.31 Typical High $0.56 | Professional | 53 · Discontinued | $0.28 | $0.31 | $0.56 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.00 Median $1.20 Typical High $2.34 | Professional | QW · Waived lab test | $1.00 | $1.20 | $2.34 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $0.89 Median $1.70 Typical High $6.46 | Facility | 52 · Reduced service | $0.89 | $1.70 | $6.46 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.36 Median $0.68 Typical High $2.57 | Facility | 53 · Discontinued | $0.36 | $0.68 | $2.57 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $37.15 Median $56.23 Typical High $93.33 | Facility | 91 · Repeat lab test | $37.15 | $56.23 | $93.33 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $35.48 Median $57.54 Typical High $72.44 | Facility | XU · Unusual separate service | $35.48 | $57.54 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $0.74 Typical High $1.15 | Professional | 52 · Reduced service | $0.71 | $0.74 | $1.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.29 Typical High $0.46 | Professional | 53 · Discontinued | $0.28 | $0.29 | $0.46 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $1.41 Median $2.34 Typical High $2.82 | Professional | QW · Waived lab test | $1.41 | $2.34 | $2.82 |
Where Texas sits
The same service costs 16.6 times more in Minnesota than in Washington, DC. 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· 15th of 51
$3.24
MN $31.62DC $1.91
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.