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 $4.57 Median $9.33 Typical High $15.14 | Facility | None | $4.57 | $9.33 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $6.03 Typical High $33.88 | Professional | None | $3.98 | $6.03 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $7.76 | Professional | None | $2.51 | $2.51 | $7.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $5.75 Typical High $9.33 | Facility | None | $4.07 | $5.75 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $2.09 Typical High $6.31 | Professional | None | $1.62 | $2.09 | $6.31 |
Aultcare Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aultcare Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.98 | Professional | None | $3.55 | $3.55 | $3.98 |
CareSource Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.75 | Facility | None | $5.01 | $5.01 | $5.75 |
CareSource Setting Professional Modifier None Typical Low $3.24 Median $5.01 Typical High $6.76 | Professional | None | $3.24 | $5.01 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $5.37 Typical High $10.96 | Facility | None | $3.47 | $5.37 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.16 Typical High $9.12 | Professional | None | $2.45 | $3.16 | $9.12 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.37 Median $20.42 Typical High $54.95 | Facility | None | $5.37 | $20.42 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.95 Median $3.16 Typical High $9.12 | Professional | None | $1.95 | $3.16 | $9.12 |
Molina Setting Professional Modifier None Typical Low $2.75 Median $3.80 Typical High $6.03 | Professional | None | $2.75 | $3.80 | $6.03 |
SummaCare Setting Professional Modifier None Typical Low $3.24 Median $4.27 Typical High $8.91 | Professional | None | $3.24 | $4.27 | $8.91 |
United Setting Facility Modifier None Typical Low $1.58 Median $4.47 Typical High $7.59 | Facility | None | $1.58 | $4.47 | $7.59 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.02 Typical High $7.08 | Professional | None | $2.09 | $3.02 | $7.08 |
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 $2.34 Median $4.79 Typical High $6.31 | Facility | 52 · Reduced service | $2.34 | $4.79 | $6.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.95 Median $1.91 Typical High $2.51 | Facility | 53 · Discontinued | $0.95 | $1.91 | $2.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.34 Typical High $28.18 | Professional | 52 · Reduced service | $2.00 | $2.34 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.95 Typical High $11.48 | Professional | 53 · Discontinued | $0.79 | $0.95 | $11.48 |
Where Ohio sits
The same service costs 8.9 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· 45th of 51
$4.37
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.