How much rates vary
Facilitymedian $23 · 10th to 90th $9 to $145Professionalmedian $5 · 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 $5.37 Median $7.76 Typical High $43.65 | Facility | None | $5.37 | $7.76 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.75 Typical High $11.75 | Professional | None | $5.25 | $5.75 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $4.57 Typical High $8.71 | Professional | None | $3.89 | $4.57 | $8.71 |
BCBS Texas Setting Facility Modifier None Typical Low $9.55 Median $28.84 Typical High $57.54 | Facility | None | $9.55 | $28.84 | $57.54 |
BCBS Texas Setting Professional Modifier None Typical Low $4.79 Median $5.01 Typical High $6.92 | Professional | None | $4.79 | $5.01 | $6.92 |
Baylor Scott & White Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $63.10 | Facility | None | $40.74 | $40.74 | $63.10 |
Christus Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $18.62 Typical High $35.48 | Facility | None | $8.71 | $18.62 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $14.45 | Professional | None | $5.01 | $6.17 | $14.45 |
Health Smart Setting Facility Modifier None Typical Low $13.18 Median $16.22 Typical High $16.22 | Facility | None | $13.18 | $16.22 | $16.22 |
Health Smart Setting Professional Modifier None Typical Low $7.41 Median $11.22 Typical High $16.22 | Professional | None | $7.41 | $11.22 | $16.22 |
Lucent Health Setting Professional Modifier None Typical Low $7.41 Median $11.22 Typical High $16.22 | Professional | None | $7.41 | $11.22 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $91.20 Typical High $234.42 | Facility | None | $8.71 | $91.20 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $9.55 | Professional | None | $5.25 | $6.92 | $9.55 |
Molina Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $7.24 | Professional | None | $6.46 | $7.24 | $7.24 |
Providence Setting Facility Modifier None Typical Low $6.92 Median $12.59 Typical High $35.48 | Facility | None | $6.92 | $12.59 | $35.48 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $12.88 | Professional | None | $5.01 | $6.17 | $12.88 |
United Setting Facility Modifier None Typical Low $2.95 Median $3.63 Typical High $44.67 | Facility | None | $2.95 | $3.63 | $44.67 |
United Setting Professional Modifier None Typical Low $3.63 Median $5.01 Typical High $7.08 | Professional | None | $3.63 | $5.01 | $7.08 |
Wellpoint Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
11 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 $2.88 Median $6.17 Typical High $23.44 | Facility | 52 · Reduced service | $2.88 | $6.17 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.15 Median $2.51 Typical High $9.33 | Facility | 53 · Discontinued | $1.15 | $2.51 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.57 Median $2.88 Typical High $5.25 | Professional | 52 · Reduced service | $2.57 | $2.88 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.12 Typical High $2.09 | Professional | 53 · Discontinued | $1.05 | $1.12 | $2.09 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $3.24 Median $6.17 Typical High $23.44 | Facility | 52 · Reduced service | $3.24 | $6.17 | $23.44 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.32 Median $2.51 Typical High $9.33 | Facility | 53 · Discontinued | $1.32 | $2.51 | $9.33 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $31.62 Median $39.81 Typical High $144.54 | Facility | 59 · Distinct service | $31.62 | $39.81 | $144.54 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $28.84 Median $83.18 Typical High $218.78 | Facility | 91 · Repeat lab test | $28.84 | $83.18 | $218.78 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $58.88 Median $114.82 Typical High $239.88 | Facility | XU · Unusual separate service | $58.88 | $114.82 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.57 Median $2.69 Typical High $4.17 | Professional | 52 · Reduced service | $2.57 | $2.69 | $4.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.07 Typical High $1.70 | Professional | 53 · Discontinued | $1.05 | $1.07 | $1.70 |
Where Texas sits
The same service costs 13.2 times more in Vermont 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· 32nd of 51
$8.71
VT $85.11MD $6.46
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.