How much rates vary
Facilitymedian $12 · 10th to 90th $5 to $91Professionalmedian $4 · 10th to 90th $3 to $6
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 $3.63 Median $7.41 Typical High $29.51 | Facility | None | $3.63 | $7.41 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $6.46 | Professional | None | $3.24 | $3.63 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $5.37 | Professional | None | $3.31 | $3.72 | $5.37 |
BCBS Texas Setting Facility Modifier None Typical Low $5.89 Median $17.78 Typical High $36.31 | Facility | None | $5.89 | $17.78 | $36.31 |
BCBS Texas Setting Professional Modifier None Typical Low $2.95 Median $5.01 Typical High $5.50 | Professional | None | $2.95 | $5.01 | $5.50 |
Christus Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $11.75 Typical High $22.39 | Facility | None | $5.37 | $11.75 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $8.91 | Professional | None | $3.16 | $3.80 | $8.91 |
Health Smart Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Health Smart Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.51 | Professional | None | $8.32 | $8.32 | $8.51 |
Lucent Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Moda Health Setting Facility Modifier None Typical Low $5.25 Median $56.23 Typical High $165.96 | Facility | None | $5.25 | $56.23 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $4.07 Typical High $6.31 | Professional | None | $3.24 | $4.07 | $6.31 |
Molina Setting Professional Modifier None Typical Low $4.07 Median $4.57 Typical High $4.57 | Professional | None | $4.07 | $4.57 | $4.57 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $7.94 Typical High $22.39 | Facility | None | $4.27 | $7.94 | $22.39 |
Providence Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $8.13 | Professional | None | $3.16 | $3.80 | $8.13 |
United Setting Facility Modifier None Typical Low $1.95 Median $5.37 Typical High $18.20 | Facility | None | $1.95 | $5.37 | $18.20 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.09 Typical High $4.37 | Professional | None | $2.24 | $3.09 | $4.37 |
Wellpoint Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.82 | Professional | None | $2.63 | $2.63 | $2.82 |
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 $1.82 Median $3.89 Typical High $14.45 | Facility | 52 · Reduced service | $1.82 | $3.89 | $14.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.72 Median $1.55 Typical High $5.89 | Facility | 53 · Discontinued | $0.72 | $1.55 | $5.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.78 Typical High $3.24 | Professional | 52 · Reduced service | $1.62 | $1.78 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.71 Typical High $1.29 | Professional | 53 · Discontinued | $0.65 | $0.71 | $1.29 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $2.04 Median $3.89 Typical High $14.45 | Facility | 52 · Reduced service | $2.04 | $3.89 | $14.45 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.81 Median $1.55 Typical High $5.89 | Facility | 53 · Discontinued | $0.81 | $1.55 | $5.89 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $89.13 Median $117.49 Typical High $165.96 | Facility | 59 · Distinct service | $89.13 | $117.49 | $165.96 |
Moda Health Setting Facility Modifier 91 · Repeat lab test Typical Low $36.31 Median $54.95 Typical High $131.83 | Facility | 91 · Repeat lab test | $36.31 | $54.95 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.66 Typical High $2.63 | Professional | 52 · Reduced service | $1.62 | $1.66 | $2.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.68 Typical High $1.05 | Professional | 53 · Discontinued | $0.65 | $0.68 | $1.05 |
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· 27th of 51
$5.50
KS $16.98MD $4.07
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.