How much rates vary
Facilitymedian $23 · 10th to 90th $13 to $74Professionalmedian $8 · 10th to 90th $5 to $13
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 $18.20 Typical High $67.61 | Facility | None | $8.71 | $18.20 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $8.71 Typical High $16.98 | Professional | None | $7.41 | $8.71 | $16.98 |
Ambetter Setting Professional Modifier None Typical Low $6.31 Median $6.92 Typical High $8.13 | Professional | None | $6.31 | $6.92 | $8.13 |
BCBS Texas Setting Facility Modifier None Typical Low $16.22 Median $46.77 Typical High $89.13 | Facility | None | $16.22 | $46.77 | $89.13 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $7.24 Typical High $13.18 | Professional | None | $5.01 | $7.24 | $13.18 |
Baylor Scott & White Setting Facility Modifier None Typical Low $12.59 Median $19.05 Typical High $87.10 | Facility | None | $12.59 | $19.05 | $87.10 |
Christus Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $28.84 Typical High $54.95 | Facility | None | $13.18 | $28.84 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $9.55 Typical High $21.88 | Professional | None | $7.59 | $9.55 | $21.88 |
Health Smart Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Health Smart Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | None | $20.42 | $20.42 | $23.44 |
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 $17.38 Typical High $109.65 | Facility | None | $10.00 | $17.38 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $7.94 Median $9.77 Typical High $15.49 | Professional | None | $7.94 | $9.77 | $15.49 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $11.22 Typical High $11.22 | Professional | None | $10.00 | $11.22 | $11.22 |
Providence Setting Facility Modifier None Typical Low $10.47 Median $19.50 Typical High $54.95 | Facility | None | $10.47 | $19.50 | $54.95 |
Providence Setting Professional Modifier None Typical Low $7.59 Median $9.55 Typical High $19.95 | Professional | None | $7.59 | $9.55 | $19.95 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.62 Typical High $13.18 | Facility | None | $4.79 | $5.62 | $13.18 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.59 Typical High $10.72 | Professional | None | $5.62 | $7.59 | $10.72 |
Wellpoint Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | None | $6.61 | $6.61 | $6.92 |
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 $4.47 Median $9.55 Typical High $35.48 | Facility | 52 · Reduced service | $4.47 | $9.55 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.78 Median $3.80 Typical High $14.45 | Facility | 53 · Discontinued | $1.78 | $3.80 | $14.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $4.37 Typical High $7.94 | Professional | 52 · Reduced service | $3.98 | $4.37 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.74 Typical High $3.16 | Professional | 53 · Discontinued | $1.58 | $1.74 | $3.16 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $5.01 Median $9.55 Typical High $35.48 | Facility | 52 · Reduced service | $5.01 | $9.55 | $35.48 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.00 Median $3.80 Typical High $14.45 | Facility | 53 · Discontinued | $2.00 | $3.80 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $4.07 Typical High $6.46 | Professional | 52 · Reduced service | $3.98 | $4.07 | $6.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.62 Typical High $2.57 | Professional | 53 · Discontinued | $1.58 | $1.62 | $2.57 |
Moda Health Setting Professional Modifier 90 · Outside lab Typical Low $10.00 Median $12.59 Typical High $14.45 | Professional | 90 · Outside lab | $10.00 | $12.59 | $14.45 |
Where Texas sits
The same service costs 4.2 times more in Kansas 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· 24th of 51
$13.80
KS $41.69MD $10.00
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.