How much rates vary
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 $15.49 Median $27.54 Typical High $50.12 | Facility | None | $15.49 | $27.54 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $60.26 | Professional | None | $13.80 | $14.79 | $60.26 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $21.38 Typical High $34.67 | Facility | None | $15.14 | $21.38 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $7.94 Typical High $21.88 | Professional | None | $7.41 | $7.94 | $21.88 |
CareSource Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $21.38 | Facility | None | $11.22 | $11.22 | $21.38 |
CareSource Setting Professional Modifier None Typical Low $12.02 Median $18.62 Typical High $25.12 | Professional | None | $12.02 | $18.62 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $21.88 Typical High $75.86 | Facility | None | $12.59 | $21.88 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $26.92 | Professional | None | $8.32 | $8.71 | $26.92 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.95 Median $57.54 Typical High $151.36 | Facility | None | $19.95 | $57.54 | $151.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $19.95 | Professional | None | $8.32 | $8.71 | $19.95 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $15.49 Typical High $22.39 | Professional | None | $10.23 | $15.49 | $22.39 |
SummaCare Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $22.39 | Professional | None | $12.02 | $15.85 | $22.39 |
United Setting Facility Modifier None Typical Low $6.76 Median $16.60 Typical High $28.18 | Facility | None | $6.76 | $16.60 | $28.18 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.22 Typical High $26.92 | Professional | None | $7.76 | $11.22 | $26.92 |
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 Facility Modifier 52 · Reduced service Typical Low $7.41 Median $13.49 Typical High $22.39 | Facility | 52 · Reduced service | $7.41 | $13.49 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.95 Median $5.37 Typical High $8.91 | Facility | 53 · Discontinued | $2.95 | $5.37 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.41 Typical High $43.65 | Professional | 52 · Reduced service | $7.41 | $7.41 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $2.95 Typical High $17.38 | Professional | 53 · Discontinued | $2.95 | $2.95 | $17.38 |
Where Ohio sits
The same service costs 11.7 times more in Vermont 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· 39th of 51
$14.79
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.