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 $13.80 Median $26.92 Typical High $45.71 | Facility | None | $13.80 | $26.92 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $75.86 | Professional | None | $12.02 | $18.20 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $10.47 | Professional | None | $7.59 | $8.71 | $10.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.30 Median $17.38 Typical High $27.54 | Facility | None | $12.30 | $17.38 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $9.12 Typical High $19.05 | Professional | None | $7.41 | $9.12 | $19.05 |
Aultcare Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Aultcare Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.02 | Professional | None | $10.47 | $10.47 | $12.02 |
CareSource Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $17.38 | Facility | None | $15.14 | $15.14 | $17.38 |
CareSource Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $20.42 | Professional | None | $9.77 | $15.14 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $18.20 Typical High $33.11 | Facility | None | $10.47 | $18.20 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $9.55 Typical High $21.88 | Professional | None | $7.59 | $9.55 | $21.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.76 Median $23.99 Typical High $63.10 | Facility | None | $6.76 | $23.99 | $63.10 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.48 Median $6.46 Typical High $16.98 | Professional | None | $1.48 | $6.46 | $16.98 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $11.22 Typical High $18.20 | Professional | None | $8.32 | $11.22 | $18.20 |
SummaCare Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
SummaCare Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $26.92 | Professional | None | $9.77 | $15.14 | $26.92 |
United Setting Facility Modifier None Typical Low $5.37 Median $13.49 Typical High $22.39 | Facility | None | $5.37 | $13.49 | $22.39 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.33 Typical High $21.38 | Professional | None | $6.31 | $9.33 | $21.38 |
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 $7.08 Median $14.13 Typical High $19.05 | Facility | 52 · Reduced service | $7.08 | $14.13 | $19.05 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.82 Median $5.62 Typical High $7.59 | Facility | 53 · Discontinued | $2.82 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $7.08 Typical High $56.23 | Professional | 52 · Reduced service | $6.03 | $7.08 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.82 Typical High $22.39 | Professional | 53 · Discontinued | $2.40 | $2.82 | $22.39 |
Where Ohio sits
The same service costs 7.4 times more in Vermont than in Illinois. 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· 46th of 51
$12.59
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.