How much rates vary
Facilitymedian $25 · 10th to 90th $12 to $76Professionalmedian $7 · 10th to 90th $5 to $12
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 $8.71 Median $18.62 Typical High $66.07 | Facility | None | $8.71 | $18.62 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $15.49 | Professional | None | $7.76 | $8.51 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $9.12 | Professional | None | $7.94 | $7.94 | $9.12 |
BCBS Texas Setting Facility Modifier None Typical Low $17.78 Median $46.77 Typical High $87.10 | Facility | None | $17.78 | $46.77 | $87.10 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $9.77 | Professional | None | $5.01 | $7.08 | $9.77 |
Christus Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $28.18 Typical High $53.70 | Facility | None | $13.18 | $28.18 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $21.88 | Professional | None | $7.41 | $9.33 | $21.88 |
Health Smart Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Health Smart Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | None | $19.95 | $19.95 | $22.91 |
Lucent Health Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Moda Health Setting Facility Modifier None Typical Low $10.00 Median $18.62 Typical High $109.65 | Facility | None | $10.00 | $18.62 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $7.76 Median $8.71 Typical High $12.88 | Professional | None | $7.76 | $8.71 | $12.88 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $10.96 Typical High $10.96 | Professional | None | $9.77 | $10.96 | $10.96 |
Providence Setting Facility Modifier None Typical Low $10.23 Median $19.05 Typical High $53.70 | Facility | None | $10.23 | $19.05 | $53.70 |
Providence Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $19.05 | Professional | None | $7.41 | $9.33 | $19.05 |
United Setting Facility Modifier None Typical Low $4.68 Median $5.50 Typical High $12.88 | Facility | None | $4.68 | $5.50 | $12.88 |
United Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $10.72 | Professional | None | $5.50 | $7.41 | $10.72 |
Wellpoint Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | None | $6.46 | $6.46 | $6.76 |
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 $4.37 Median $9.33 Typical High $35.48 | Facility | 52 · Reduced service | $4.37 | $9.33 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $3.72 Typical High $14.13 | Facility | 53 · Discontinued | $1.74 | $3.72 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $4.27 Typical High $7.76 | Professional | 52 · Reduced service | $3.89 | $4.27 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.74 Typical High $3.09 | Professional | 53 · Discontinued | $1.55 | $1.74 | $3.09 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4.90 Median $9.33 Typical High $35.48 | Facility | 52 · Reduced service | $4.90 | $9.33 | $35.48 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.95 Median $3.72 Typical High $14.13 | Facility | 53 · Discontinued | $1.95 | $3.72 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $4.07 Typical High $6.31 | Professional | 52 · Reduced service | $3.89 | $4.07 | $6.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.62 Typical High $2.51 | Professional | 53 · Discontinued | $1.55 | $1.62 | $2.51 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $12.30 Median $12.88 Typical High $14.45 | Professional | 90 · Outside lab | $12.30 | $12.88 | $14.45 |
Where Texas sits
The same service costs 3.0 times more in Alaska 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· 34th of 51
$11.75
AK $29.51MD $9.77
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.