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 $10.00 Typical High $13.80 | Facility | None | $4.57 | $10.00 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $6.03 Typical High $15.14 | Professional | None | $3.72 | $6.03 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.09 | Professional | None | $2.29 | $2.29 | $3.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.72 Median $5.37 Typical High $8.51 | Facility | None | $3.72 | $5.37 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $4.27 | Professional | None | $2.29 | $2.29 | $4.27 |
CareSource Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $5.25 | Facility | None | $3.09 | $3.09 | $5.25 |
CareSource Setting Professional Modifier None Typical Low $3.02 Median $4.57 Typical High $6.17 | Professional | None | $3.02 | $4.57 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $4.90 Typical High $10.00 | Facility | None | $3.02 | $4.90 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $3.02 Typical High $6.46 | Professional | None | $2.29 | $3.02 | $6.46 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.90 Median $7.24 Typical High $25.70 | Facility | None | $4.90 | $7.24 | $25.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.29 Median $2.63 Typical High $6.46 | Professional | None | $2.29 | $2.63 | $6.46 |
Molina Setting Professional Modifier None Typical Low $2.51 Median $3.47 Typical High $5.50 | Professional | None | $2.51 | $3.47 | $5.50 |
SummaCare Setting Professional Modifier None Typical Low $3.02 Median $3.89 Typical High $6.31 | Professional | None | $3.02 | $3.89 | $6.31 |
United Setting Facility Modifier None Typical Low $1.66 Median $4.17 Typical High $6.92 | Facility | None | $1.66 | $4.17 | $6.92 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.82 Typical High $6.61 | Professional | None | $1.95 | $2.82 | $6.61 |
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 $2.19 Median $4.37 Typical High $5.75 | Facility | 52 · Reduced service | $2.19 | $4.37 | $5.75 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.87 Median $1.78 Typical High $2.29 | Facility | 53 · Discontinued | $0.87 | $1.78 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $2.00 Typical High $7.08 | Professional | 52 · Reduced service | $1.82 | $2.00 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.79 Typical High $2.82 | Professional | 53 · Discontinued | $0.74 | $0.79 | $2.82 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.16 Median $5.25 Typical High $6.76 | Professional | QW · Waived lab test | $3.16 | $5.25 | $6.76 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $3.02 Median $3.89 Typical High $5.50 | Professional | QW · Waived lab test | $3.02 | $3.89 | $5.50 |
Where Ohio sits
The same service costs 4.4 times more in Minnesota 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· 43rd of 51
$3.80
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.