How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $28Professionalmedian $4 · 10th to 90th $3 to $9
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 $5.37 Median $10.96 Typical High $21.38 | Facility | None | $5.37 | $10.96 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $21.88 | Professional | None | $4.57 | $6.92 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $3.31 Typical High $4.57 | Professional | None | $2.88 | $3.31 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $6.76 Typical High $10.72 | Facility | None | $4.68 | $6.76 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $5.37 | Professional | None | $2.88 | $2.88 | $5.37 |
Aultcare Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.57 | Facility | None | $3.89 | $3.89 | $4.57 |
Aultcare Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.57 | Professional | None | $4.07 | $4.07 | $4.57 |
CareSource Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $6.61 | Facility | None | $5.75 | $5.75 | $6.61 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $7.76 | Professional | None | $3.80 | $5.75 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $6.92 Typical High $12.59 | Facility | None | $3.98 | $6.92 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.63 Typical High $7.94 | Professional | None | $2.95 | $3.63 | $7.94 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.25 Median $16.60 Typical High $79.43 | Facility | None | $5.25 | $16.60 | $79.43 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.14 Median $3.63 Typical High $8.13 | Professional | None | $2.14 | $3.63 | $8.13 |
Molina Setting Professional Modifier None Typical Low $3.16 Median $4.37 Typical High $6.92 | Professional | None | $3.16 | $4.37 | $6.92 |
SummaCare Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
SummaCare Setting Professional Modifier None Typical Low $4.37 Median $5.75 Typical High $10.47 | Professional | None | $4.37 | $5.75 | $10.47 |
United Setting Facility Modifier None Typical Low $2.09 Median $5.25 Typical High $8.71 | Facility | None | $2.09 | $5.25 | $8.71 |
United Setting Professional Modifier None Typical Low $2.45 Median $4.07 Typical High $8.32 | Professional | None | $2.45 | $4.07 | $8.32 |
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 $2.75 Median $5.50 Typical High $13.80 | Facility | 52 · Reduced service | $2.75 | $5.50 | $13.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.10 Median $2.19 Typical High $5.50 | Facility | 53 · Discontinued | $1.10 | $2.19 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.29 Median $2.75 Typical High $25.70 | Professional | 52 · Reduced service | $2.29 | $2.75 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.10 Typical High $10.47 | Professional | 53 · Discontinued | $0.91 | $1.10 | $10.47 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $2.88 Typical High $8.91 | Professional | QW · Waived lab test | $2.45 | $2.88 | $8.91 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.98 Median $7.24 Typical High $8.51 | Professional | QW · Waived lab test | $3.98 | $7.24 | $8.51 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $3.80 Median $4.90 Typical High $6.92 | Professional | QW · Waived lab test | $3.80 | $4.90 | $6.92 |
Where Ohio sits
The same service costs 12.9 times more in Vermont than in Alabama. 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· 44th of 51
$4.90
VT $51.29AL $3.98
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.