How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $19Professionalmedian $2 · 10th to 90th $1 to $4
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 $2.09 Median $4.90 Typical High $8.32 | Facility | None | $2.09 | $4.90 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $1.82 Median $2.69 Typical High $12.88 | Professional | None | $1.82 | $2.69 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $1.29 Median $1.35 Typical High $3.47 | Professional | None | $1.29 | $1.35 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.82 Median $2.63 Typical High $4.17 | Facility | None | $1.82 | $2.63 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $1.12 Typical High $1.91 | Professional | None | $0.89 | $1.12 | $1.91 |
Aultcare Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $2.24 | Facility | None | $1.51 | $1.51 | $2.24 |
Aultcare Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
CareSource Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $2.57 | Facility | None | $1.32 | $1.32 | $2.57 |
CareSource Setting Professional Modifier None Typical Low $1.45 Median $2.24 Typical High $3.02 | Professional | None | $1.45 | $2.24 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $1.48 Median $2.69 Typical High $8.32 | Facility | None | $1.48 | $2.69 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $1.15 Median $1.48 Typical High $3.89 | Professional | None | $1.15 | $1.48 | $3.89 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.95 Median $12.88 Typical High $35.48 | Facility | None | $2.95 | $12.88 | $35.48 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.83 Median $1.45 Typical High $3.89 | Professional | None | $0.83 | $1.45 | $3.89 |
Molina Setting Professional Modifier None Typical Low $1.23 Median $1.58 Typical High $2.69 | Professional | None | $1.23 | $1.58 | $2.69 |
SummaCare Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
SummaCare Setting Professional Modifier None Typical Low $1.70 Median $2.45 Typical High $4.90 | Professional | None | $1.70 | $2.45 | $4.90 |
United Setting Facility Modifier None Typical Low $0.81 Median $2.04 Typical High $3.39 | Facility | None | $0.81 | $2.04 | $3.39 |
United Setting Professional Modifier None Typical Low $1.26 Median $2.24 Typical High $3.24 | Professional | None | $1.26 | $2.24 | $3.24 |
7 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 $1.07 Median $2.45 Typical High $7.94 | Facility | 52 · Reduced service | $1.07 | $2.45 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.42 Median $1.00 Typical High $3.24 | Facility | 53 · Discontinued | $0.42 | $1.00 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.89 Median $1.07 Typical High $7.94 | Professional | 52 · Reduced service | $0.89 | $1.07 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.42 Typical High $3.24 | Professional | 53 · Discontinued | $0.36 | $0.42 | $3.24 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.12 Median $1.41 Typical High $95.50 | Professional | QW · Waived lab test | $1.12 | $1.41 | $95.50 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $1.55 Median $2.82 Typical High $3.63 | Professional | QW · Waived lab test | $1.55 | $2.82 | $3.63 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $1.45 Median $1.91 Typical High $2.69 | Professional | QW · Waived lab test | $1.45 | $1.91 | $2.69 |
Where Ohio sits
The same service costs 20.4 times more in Vermont 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· 38th of 51
$2.24
VT $37.15DC $1.82
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.