How much rates vary
Facilitymedian $158 · 10th to 90th $22 to $1,549Professionalmedian $52 · 10th to 90th $35 to $98
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 $40.74 Median $83.18 Typical High $158.49 | Facility | None | $40.74 | $83.18 | $158.49 |
Aetna Setting Facility Modifier 26 · Professional part Typical Low $24.55 Median $52.48 Typical High $100.00 | Facility | 26 · Professional part | $24.55 | $52.48 | $100.00 |
Aetna Setting Facility Modifier TC · Technical part Typical Low $15.14 Median $31.62 Typical High $57.54 | Facility | TC · Technical part | $15.14 | $31.62 | $57.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $38.90 Median $50.12 Typical High $128.82 | Professional | None (both parts) | $38.90 | $50.12 | $128.82 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $30.90 Typical High $81.28 | Professional | 26 · Professional part | $23.44 | $30.90 | $81.28 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $19.05 Typical High $46.77 | Professional | TC · Technical part | $15.14 | $19.05 | $46.77 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $44.67 Median $57.54 Typical High $74.13 | Professional | None (both parts) | $44.67 | $57.54 | $74.13 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $34.67 Typical High $47.86 | Professional | 26 · Professional part | $27.54 | $34.67 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $1,318.26 Typical High $16,595.87 | Facility | None | $398.11 | $1,318.26 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $34.67 Median $45.71 Typical High $83.18 | Professional | None (both parts) | $34.67 | $45.71 | $83.18 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $38.90 Typical High $54.95 | Professional | 26 · Professional part | $27.54 | $38.90 | $54.95 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $7.59 Median $10.23 Typical High $26.92 | Professional | TC · Technical part | $7.59 | $10.23 | $26.92 |
CareSource Setting Facility Modifier None Typical Low $18.62 Median $24.55 Typical High $58.88 | Facility | None | $18.62 | $24.55 | $58.88 |
CareSource Setting Professional Modifier None (both parts) Typical Low $21.38 Median $34.67 Typical High $61.66 | Professional | None (both parts) | $21.38 | $34.67 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $23.44 Typical High $37.15 | Facility | None | $19.50 | $23.44 | $37.15 |
Cigna Setting Professional Modifier None (both parts) Typical Low $45.71 Median $52.48 Typical High $97.72 | Professional | None (both parts) | $45.71 | $52.48 | $97.72 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $31.62 Typical High $63.10 | Professional | 26 · Professional part | $28.84 | $31.62 | $63.10 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $21.38 Typical High $36.31 | Professional | TC · Technical part | $16.98 | $21.38 | $36.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.38 Median $288.40 Typical High $575.44 | Facility | None | $21.38 | $288.40 | $575.44 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $45.71 Median $52.48 Typical High $97.72 | Professional | None (both parts) | $45.71 | $52.48 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $31.62 Typical High $63.10 | Professional | 26 · Professional part | $27.54 | $31.62 | $63.10 |
Medical Mutual of Ohio Setting Professional Modifier TC · Technical part Typical Low $16.98 Median $21.38 Typical High $36.31 | Professional | TC · Technical part | $16.98 | $21.38 | $36.31 |
Molina Setting Professional Modifier None (both parts) Typical Low $32.36 Median $52.48 Typical High $100.00 | Professional | None (both parts) | $32.36 | $52.48 | $100.00 |
SummaCare Setting Facility Modifier None Typical Low $10.72 Median $11.22 Typical High $12.88 | Facility | None | $10.72 | $11.22 | $12.88 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $42.66 Median $56.23 Typical High $85.11 | Professional | None (both parts) | $42.66 | $56.23 | $85.11 |
SummaCare Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $35.48 Typical High $51.29 | Professional | 26 · Professional part | $30.20 | $35.48 | $51.29 |
SummaCare Setting Professional Modifier TC · Technical part Typical Low $9.33 Median $20.42 Typical High $31.62 | Professional | TC · Technical part | $9.33 | $20.42 | $31.62 |
United Setting Facility Modifier None Typical Low $97.72 Median $275.42 Typical High $2,398.83 | Facility | None | $97.72 | $275.42 | $2,398.83 |
United Setting Professional Modifier None (both parts) Typical Low $41.69 Median $52.48 Typical High $107.15 | Professional | None (both parts) | $41.69 | $52.48 | $107.15 |
United Setting Professional Modifier 26 · Professional part Typical Low $26.92 Median $33.88 Typical High $66.07 | Professional | 26 · Professional part | $26.92 | $33.88 | $66.07 |
United Setting Professional Modifier TC · Technical part Typical Low $13.80 Median $19.50 Typical High $39.81 | Professional | TC · Technical part | $13.80 | $19.50 | $39.81 |
4 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 Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $57.54 | Professional | 52 · Reduced service | $19.50 | $19.50 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $23.44 | Professional | 53 · Discontinued | $7.76 | $7.76 | $23.44 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 59 · Distinct service | $43.65 | $43.65 | $43.65 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | UD · State-defined | $37.15 | $37.15 | $37.15 |
Where Ohio sits
The same service costs 6.5 times more in Minnesota than in Kentucky. 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.
Ohio· 44th of 51
$53.70
MN $295KY $45.71
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.