How much rates vary
Facilitymedian $166 · 10th to 90th $60 to $380Professionalmedian $87 · 10th to 90th $5 to $525
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 $44.67 Median $91.20 Typical High $354.81 | Facility | None | $44.67 | $91.20 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $93.33 | Professional | None | $38.90 | $46.77 | $93.33 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $239.88 Typical High $407.38 | Facility | None | $95.50 | $239.88 | $407.38 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $38.90 Typical High $95.50 | Professional | None | $5.01 | $38.90 | $95.50 |
Christus Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $151.36 Typical High $218.78 | Facility | None | $57.54 | $151.36 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $131.83 | Professional | None | $37.15 | $63.10 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $524.81 | Professional | None | $354.81 | $524.81 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $165.96 Typical High $416.87 | Facility | None | $53.70 | $165.96 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $104.71 | Professional | None | $38.90 | $46.77 | $104.71 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | None | $58.88 | $58.88 | $67.61 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $162.18 Typical High $295.12 | Facility | None | $56.23 | $162.18 | $295.12 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $123.03 | Professional | None | $37.15 | $64.57 | $123.03 |
United Setting Facility Modifier None Typical Low $25.12 Median $29.51 Typical High $70.79 | Facility | None | $25.12 | $29.51 | $70.79 |
United Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $52.48 | Professional | None | $29.51 | $36.31 | $52.48 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $22.91 Median $50.12 Typical High $190.55 | Facility | 52 · Reduced service | $22.91 | $50.12 | $190.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.33 Median $20.42 Typical High $75.86 | Facility | 53 · Discontinued | $9.33 | $20.42 | $75.86 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $21.88 Typical High $33.11 | Professional | 52 · Reduced service | $20.89 | $21.88 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.91 Typical High $13.18 | Professional | 53 · Discontinued | $8.51 | $8.91 | $13.18 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $35.48 Median $35.48 Typical High $70.79 | Professional | QW · Waived lab test | $35.48 | $35.48 | $70.79 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $26.30 Median $50.12 Typical High $190.55 | Facility | 52 · Reduced service | $26.30 | $50.12 | $190.55 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $10.72 Median $20.42 Typical High $75.86 | Facility | 53 · Discontinued | $10.72 | $20.42 | $75.86 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $295.12 Median $398.11 Typical High $436.52 | Facility | 59 · Distinct service | $295.12 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $21.88 Typical High $28.18 | Professional | 52 · Reduced service | $20.89 | $21.88 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $8.71 | $11.22 |
Moda Health Setting Professional Modifier QW · Waived lab test Typical Low $60.26 Median $77.62 Typical High $125.89 | Professional | QW · Waived lab test | $60.26 | $77.62 | $125.89 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in Alabama. 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· 7th of 51
$95.50
AK $158AL $39.81
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.