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 $13.18 Median $28.18 Typical High $44.67 | Facility | None | $13.18 | $28.18 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $64.57 | Professional | None | $11.75 | $14.45 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $22.39 Typical High $22.39 | Professional | None | $3.89 | $22.39 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $16.98 Typical High $26.92 | Facility | None | $11.75 | $16.98 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $18.20 | Professional | None | $7.24 | $7.59 | $18.20 |
Aultcare Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aultcare Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
CareSource Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $16.60 | Facility | None | $9.77 | $9.77 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $19.50 | Professional | None | $9.55 | $14.45 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $17.38 Typical High $31.62 | Facility | None | $9.55 | $17.38 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $21.38 | Professional | None | $7.41 | $9.33 | $21.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $15.49 Median $26.30 Typical High $81.28 | Facility | None | $15.49 | $26.30 | $81.28 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.62 Median $9.33 Typical High $20.42 | Professional | None | $5.62 | $9.33 | $20.42 |
Molina Setting Professional Modifier None Typical Low $7.94 Median $10.96 Typical High $17.38 | Professional | None | $7.94 | $10.96 | $17.38 |
SummaCare Setting Professional Modifier None Typical Low $9.55 Median $12.30 Typical High $19.95 | Professional | None | $9.55 | $12.30 | $19.95 |
United Setting Facility Modifier None Typical Low $5.25 Median $14.45 Typical High $30.20 | Facility | None | $5.25 | $14.45 | $30.20 |
United Setting Professional Modifier None Typical Low $6.17 Median $10.23 Typical High $20.89 | Professional | None | $6.17 | $10.23 | $20.89 |
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 $6.92 Median $13.80 Typical High $20.89 | Facility | 52 · Reduced service | $6.92 | $13.80 | $20.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.75 Median $5.62 Typical High $8.32 | Facility | 53 · Discontinued | $2.75 | $5.62 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $6.92 Typical High $46.77 | Professional | 52 · Reduced service | $5.89 | $6.92 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.75 Typical High $18.62 | Professional | 53 · Discontinued | $2.34 | $2.75 | $18.62 |
Where Ohio sits
The same service costs 10.2 times more in Vermont than in Maryland. 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· 40th of 51
$12.30
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.