How much rates vary
Facilitymedian $13 · 10th to 90th $8 to $35Professionalmedian $5 · 10th to 90th $4 to $15
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 $7.94 Median $16.22 Typical High $26.30 | Facility | None | $7.94 | $16.22 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $10.47 Typical High $40.74 | Professional | None | $6.92 | $10.47 | $40.74 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $13.49 | Professional | None | $4.37 | $4.37 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $10.00 Typical High $15.85 | Facility | None | $7.08 | $10.00 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $7.59 | Professional | None | $3.47 | $4.27 | $7.59 |
Aultcare Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aultcare Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.92 | Professional | None | $6.03 | $6.03 | $6.92 |
CareSource Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $10.00 | Facility | None | $8.71 | $8.71 | $10.00 |
CareSource Setting Professional Modifier None Typical Low $5.62 Median $8.71 Typical High $11.75 | Professional | None | $5.62 | $8.71 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $9.33 Typical High $19.05 | Facility | None | $5.75 | $9.33 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $5.50 Typical High $12.02 | Professional | None | $4.47 | $5.50 | $12.02 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $9.33 Median $28.84 Typical High $120.23 | Facility | None | $9.33 | $28.84 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.24 Median $5.37 Typical High $14.45 | Professional | None | $3.24 | $5.37 | $14.45 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $6.46 Typical High $10.47 | Professional | None | $4.79 | $6.46 | $10.47 |
SummaCare Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $15.49 | Professional | None | $5.62 | $8.32 | $15.49 |
United Setting Facility Modifier None Typical Low $3.09 Median $7.76 Typical High $12.88 | Facility | None | $3.09 | $7.76 | $12.88 |
United Setting Professional Modifier None Typical Low $3.63 Median $5.37 Typical High $12.30 | Professional | None | $3.63 | $5.37 | $12.30 |
6 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 $4.07 Median $8.32 Typical High $10.96 | Facility | 52 · Reduced service | $4.07 | $8.32 | $10.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $3.31 Typical High $4.37 | Facility | 53 · Discontinued | $1.62 | $3.31 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $4.07 Typical High $30.20 | Professional | 52 · Reduced service | $3.47 | $4.07 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.62 Typical High $12.30 | Professional | 53 · Discontinued | $1.38 | $1.62 | $12.30 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $6.03 Median $10.00 Typical High $12.59 | Professional | QW · Waived lab test | $6.03 | $10.00 | $12.59 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $5.62 Median $7.41 Typical High $10.47 | Professional | QW · Waived lab test | $5.62 | $7.41 | $10.47 |
Where Ohio sits
The same service costs 10.5 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.
Ohio· 45th of 51
$7.08
VT $67.61MD $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.