How much rates vary
Facilitymedian $20 · 10th to 90th $12 to $50Professionalmedian $9 · 10th to 90th $7 to $24
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 $12.88 Median $24.55 Typical High $41.69 | Facility | None | $12.88 | $24.55 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $50.12 | Professional | None | $10.96 | $15.85 | $50.12 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | None | $8.13 | $8.13 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.96 Median $15.85 Typical High $25.12 | Facility | None | $10.96 | $15.85 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $12.59 | Professional | None | $6.76 | $6.76 | $12.59 |
Aultcare Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aultcare Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $15.85 | Facility | None | $8.32 | $8.32 | $15.85 |
CareSource Setting Professional Modifier None Typical Low $8.91 Median $13.80 Typical High $18.62 | Professional | None | $8.91 | $13.80 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $16.60 Typical High $29.51 | Facility | None | $8.91 | $16.60 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $8.71 Typical High $19.50 | Professional | None | $6.92 | $8.71 | $19.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $14.79 Median $37.15 Typical High $83.18 | Facility | None | $14.79 | $37.15 | $83.18 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $22.91 | Professional | None | $6.92 | $9.12 | $22.91 |
Molina Setting Professional Modifier None Typical Low $7.59 Median $10.23 Typical High $16.60 | Professional | None | $7.59 | $10.23 | $16.60 |
SummaCare Setting Professional Modifier None Typical Low $8.91 Median $11.75 Typical High $26.92 | Professional | None | $8.91 | $11.75 | $26.92 |
United Setting Facility Modifier None Typical Low $4.79 Median $12.30 Typical High $36.31 | Facility | None | $4.79 | $12.30 | $36.31 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $19.50 | Professional | None | $5.75 | $8.32 | $19.50 |
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 $6.46 Median $12.59 Typical High $17.38 | Facility | 52 · Reduced service | $6.46 | $12.59 | $17.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.57 Median $5.13 Typical High $6.92 | Facility | 53 · Discontinued | $2.57 | $5.13 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $6.46 Typical High $54.95 | Professional | 52 · Reduced service | $5.50 | $6.46 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.57 Typical High $21.88 | Professional | 53 · Discontinued | $2.19 | $2.57 | $21.88 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $9.33 Median $15.85 Typical High $19.95 | Professional | QW · Waived lab test | $9.33 | $15.85 | $19.95 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $8.91 Median $11.75 Typical High $16.60 | Professional | QW · Waived lab test | $8.91 | $11.75 | $16.60 |
Where Ohio sits
The same service costs 9.5 times more in Vermont than in Rhode Island. 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
$11.75
VT $97.72RI $10.23
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.