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 $4.07 Median $8.91 Typical High $13.49 | Facility | None | $4.07 | $8.91 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $4.37 Typical High $13.18 | Professional | None | $3.24 | $4.37 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $1.70 Median $2.00 Typical High $2.63 | Professional | None | $1.70 | $2.00 | $2.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $4.68 Typical High $7.41 | Facility | None | $3.24 | $4.68 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $4.07 Typical High $6.46 | Professional | None | $2.75 | $4.07 | $6.46 |
CareSource Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $4.57 | Facility | None | $2.34 | $2.34 | $4.57 |
CareSource Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $5.37 | Professional | None | $2.63 | $3.98 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $2.63 Median $4.27 Typical High $8.71 | Facility | None | $2.63 | $4.27 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $2.63 Typical High $5.75 | Professional | None | $1.82 | $2.63 | $5.75 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.69 Median $4.68 Typical High $16.98 | Facility | None | $2.69 | $4.68 | $16.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $5.75 | Professional | None | $1.82 | $2.19 | $5.75 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $3.02 Typical High $4.79 | Professional | None | $2.19 | $3.02 | $4.79 |
SummaCare Setting Professional Modifier None Typical Low $2.63 Median $3.39 Typical High $4.79 | Professional | None | $2.63 | $3.39 | $4.79 |
United Setting Facility Modifier None Typical Low $1.45 Median $3.98 Typical High $8.91 | Facility | None | $1.45 | $3.98 | $8.91 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.72 Typical High $4.79 | Professional | None | $2.40 | $3.72 | $4.79 |
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 $1.91 Median $3.98 Typical High $6.61 | Facility | 52 · Reduced service | $1.91 | $3.98 | $6.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.76 Median $1.58 Typical High $2.63 | Facility | 53 · Discontinued | $0.76 | $1.58 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.91 Typical High $6.61 | Professional | 52 · Reduced service | $1.62 | $1.91 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.76 Typical High $2.63 | Professional | 53 · Discontinued | $0.65 | $0.76 | $2.63 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in North Carolina. 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· 24th of 51
$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.