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 $2.95 Median $6.92 Typical High $11.48 | Facility | None | $2.95 | $6.92 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.80 Typical High $11.75 | Professional | None | $2.51 | $3.80 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $1.58 Median $1.91 Typical High $3.16 | Professional | None | $1.58 | $1.91 | $3.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.57 Median $3.72 Typical High $5.89 | Facility | None | $2.57 | $3.72 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $3.89 Typical High $5.62 | Professional | None | $2.19 | $3.89 | $5.62 |
Aultcare Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
Aultcare Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.63 | Facility | None | $3.16 | $3.16 | $3.63 |
CareSource Setting Professional Modifier None Typical Low $2.04 Median $3.16 Typical High $4.27 | Professional | None | $2.04 | $3.16 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $3.80 Typical High $9.12 | Facility | None | $2.19 | $3.80 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $2.24 Typical High $5.75 | Professional | None | $1.66 | $2.24 | $5.75 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.25 Median $19.95 Typical High $58.88 | Facility | None | $5.25 | $19.95 | $58.88 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.20 Median $2.04 Typical High $5.62 | Professional | None | $1.20 | $2.04 | $5.62 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $2.24 Typical High $3.80 | Professional | None | $1.74 | $2.24 | $3.80 |
SummaCare Setting Professional Modifier None Typical Low $2.04 Median $3.02 Typical High $5.75 | Professional | None | $2.04 | $3.02 | $5.75 |
United Setting Facility Modifier None Typical Low $1.12 Median $2.82 Typical High $4.79 | Facility | None | $1.12 | $2.82 | $4.79 |
United Setting Professional Modifier None Typical Low $1.91 Median $3.16 Typical High $4.57 | Professional | None | $1.91 | $3.16 | $4.57 |
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 $1.51 Median $3.47 Typical High $5.75 | Facility | 52 · Reduced service | $1.51 | $3.47 | $5.75 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.60 Median $1.41 Typical High $2.29 | Facility | 53 · Discontinued | $0.60 | $1.41 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.51 Typical High $22.39 | Professional | 52 · Reduced service | $1.26 | $1.51 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.60 Typical High $8.91 | Professional | 53 · Discontinued | $0.51 | $0.60 | $8.91 |
Where Ohio sits
The same service costs 22.4 times more in Minnesota than in Washington, DC. 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· 19th of 51
$3.89
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.