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 $4.90 Median $9.77 Typical High $15.49 | Facility | None | $4.90 | $9.77 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $19.05 | Professional | None | $4.17 | $6.03 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $7.94 | Professional | None | $2.57 | $2.57 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $6.03 Typical High $9.55 | Facility | None | $4.17 | $6.03 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $4.79 | Professional | None | $2.51 | $2.51 | $4.79 |
Aultcare Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
CareSource Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $5.89 | Facility | None | $3.47 | $3.47 | $5.89 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $6.92 | Professional | None | $3.39 | $5.13 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $6.17 Typical High $11.22 | Facility | None | $3.39 | $6.17 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $3.31 Typical High $7.24 | Professional | None | $2.63 | $3.31 | $7.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.50 Median $8.91 Typical High $37.15 | Facility | None | $5.50 | $8.91 | $37.15 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.45 Median $3.39 Typical High $12.02 | Professional | None | $2.45 | $3.39 | $12.02 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $6.17 | Professional | None | $2.82 | $3.89 | $6.17 |
SummaCare Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $10.23 | Professional | None | $3.39 | $4.90 | $10.23 |
United Setting Facility Modifier None Typical Low $1.86 Median $5.13 Typical High $12.02 | Facility | None | $1.86 | $5.13 | $12.02 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $7.41 | Professional | None | $2.19 | $3.16 | $7.41 |
6 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 $2.45 Median $4.90 Typical High $6.46 | Facility | 52 · Reduced service | $2.45 | $4.90 | $6.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.98 Median $1.95 Typical High $2.57 | Facility | 53 · Discontinued | $0.98 | $1.95 | $2.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.45 Typical High $10.00 | Professional | 52 · Reduced service | $2.04 | $2.45 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.98 Typical High $3.98 | Professional | 53 · Discontinued | $0.83 | $0.98 | $3.98 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.55 Median $6.46 Typical High $8.32 | Professional | QW · Waived lab test | $3.55 | $6.46 | $8.32 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $3.39 Median $4.37 Typical High $6.17 | Professional | QW · Waived lab test | $3.39 | $4.37 | $6.17 |
Where Ohio sits
The same service costs 8.1 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.