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 $3.47 Median $7.59 Typical High $11.48 | Facility | None | $3.47 | $7.59 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $3.89 Typical High $11.48 | Professional | None | $2.75 | $3.89 | $11.48 |
Ambetter Setting Professional Modifier None Typical Low $1.48 Median $1.74 Typical High $3.72 | Professional | None | $1.48 | $1.74 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.82 Median $4.07 Typical High $6.46 | Facility | None | $2.82 | $4.07 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.75 Typical High $4.68 | Professional | None | $2.00 | $2.75 | $4.68 |
CareSource Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $3.98 | Facility | None | $2.04 | $2.04 | $3.98 |
CareSource Setting Professional Modifier None Typical Low $2.24 Median $3.47 Typical High $4.68 | Professional | None | $2.24 | $3.47 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $4.17 Typical High $7.59 | Facility | None | $2.29 | $4.17 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $2.24 Typical High $4.57 | Professional | None | $1.66 | $2.24 | $4.57 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.63 Median $6.92 Typical High $26.92 | Facility | None | $3.63 | $6.92 | $26.92 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.66 Median $1.86 Typical High $4.37 | Professional | None | $1.66 | $1.86 | $4.37 |
Molina Setting Professional Modifier None Typical Low $1.91 Median $2.63 Typical High $4.17 | Professional | None | $1.91 | $2.63 | $4.17 |
SummaCare Setting Professional Modifier None Typical Low $2.24 Median $3.31 Typical High $6.92 | Professional | None | $2.24 | $3.31 | $6.92 |
United Setting Facility Modifier None Typical Low $1.26 Median $3.16 Typical High $5.25 | Facility | None | $1.26 | $3.16 | $5.25 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.75 Typical High $4.17 | Professional | None | $1.95 | $2.75 | $4.17 |
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 $1.62 Median $3.31 Typical High $6.31 | Facility | 52 · Reduced service | $1.62 | $3.31 | $6.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.66 Median $1.32 Typical High $2.51 | Facility | 53 · Discontinued | $0.66 | $1.32 | $2.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.38 Median $1.62 Typical High $6.31 | Professional | 52 · Reduced service | $1.38 | $1.62 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.65 Typical High $2.51 | Professional | 53 · Discontinued | $0.56 | $0.65 | $2.51 |
Where Ohio sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 36th of 51
$3.24
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.