How much rates vary
Facilitymedian $22 · 10th to 90th $12 to $66Professionalmedian $7 · 10th to 90th $5 to $10
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 $14.79 Typical High $58.88 | Facility | None | $7.08 | $14.79 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $13.80 | Professional | None | $6.92 | $7.24 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $10.23 | Professional | None | $5.75 | $7.41 | $10.23 |
BCBS Texas Setting Facility Modifier None Typical Low $15.85 Median $41.69 Typical High $77.62 | Facility | None | $15.85 | $41.69 | $77.62 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $6.61 Typical High $7.41 | Professional | None | $5.01 | $6.61 | $7.41 |
Christus Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $26.30 Typical High $37.15 | Facility | None | $7.94 | $26.30 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $16.98 | Professional | None | $4.79 | $6.17 | $16.98 |
Health Smart Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $18.20 | Professional | None | $10.23 | $11.48 | $18.20 |
Lucent Health Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $18.20 | Professional | None | $10.23 | $11.48 | $18.20 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $20.42 Typical High $114.82 | Facility | None | $8.71 | $20.42 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $6.46 Median $8.71 Typical High $10.96 | Professional | None | $6.46 | $8.71 | $10.96 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $9.12 Typical High $10.23 | Professional | None | $8.51 | $9.12 | $10.23 |
Providence Setting Facility Modifier None Typical Low $8.51 Median $12.59 Typical High $37.15 | Facility | None | $8.51 | $12.59 | $37.15 |
Providence Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $12.02 | Professional | None | $4.79 | $6.17 | $12.02 |
United Setting Facility Modifier None Typical Low $4.37 Median $5.01 Typical High $12.02 | Facility | None | $4.37 | $5.01 | $12.02 |
United Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $11.48 | Professional | None | $4.79 | $4.79 | $11.48 |
Wellpoint Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $6.31 | Professional | None | $4.57 | $4.57 | $6.31 |
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 $3.80 Median $8.32 Typical High $30.90 | Facility | 52 · Reduced service | $3.80 | $8.32 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.51 Median $3.31 Typical High $12.59 | Facility | 53 · Discontinued | $1.51 | $3.31 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.80 Typical High $6.92 | Professional | 52 · Reduced service | $3.47 | $3.80 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.51 Typical High $2.82 | Professional | 53 · Discontinued | $1.38 | $1.51 | $2.82 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4.37 Median $8.32 Typical High $30.90 | Facility | 52 · Reduced service | $4.37 | $8.32 | $30.90 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $3.31 Typical High $12.59 | Facility | 53 · Discontinued | $1.74 | $3.31 | $12.59 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $54.95 Median $114.82 Typical High $120.23 | Facility | XU · Unusual separate service | $54.95 | $114.82 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.55 Typical High $5.37 | Professional | 52 · Reduced service | $3.47 | $3.55 | $5.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.45 Typical High $2.19 | Professional | 53 · Discontinued | $1.38 | $1.45 | $2.19 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $8.13 Median $12.02 Typical High $14.45 | Professional | 90 · Outside lab | $8.13 | $12.02 | $14.45 |
Where Texas sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 17th of 51
$12.59
AK $33.11NJ $8.13
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.