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 $26.30 Median $50.12 Typical High $85.11 | Facility | None | $26.30 | $50.12 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $112.20 | Professional | None | $22.39 | $33.11 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $22.39 | Professional | None | $14.13 | $16.60 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $32.36 Typical High $51.29 | Facility | None | $22.39 | $32.36 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $35.48 | Professional | None | $13.80 | $14.79 | $35.48 |
Aultcare Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aultcare Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $32.36 | Facility | None | $19.05 | $19.05 | $32.36 |
CareSource Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $38.02 | Professional | None | $18.20 | $28.18 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $33.88 Typical High $60.26 | Facility | None | $19.50 | $33.88 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $17.78 Typical High $39.81 | Professional | None | $14.13 | $17.78 | $39.81 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $19.95 Median $51.29 Typical High $177.83 | Facility | None | $19.95 | $51.29 | $177.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $11.22 Median $18.20 Typical High $44.67 | Professional | None | $11.22 | $18.20 | $44.67 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $20.89 Typical High $33.88 | Professional | None | $15.49 | $20.89 | $33.88 |
SummaCare Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $50.12 | Professional | None | $18.20 | $26.30 | $50.12 |
United Setting Facility Modifier None Typical Low $10.00 Median $28.18 Typical High $89.13 | Facility | None | $10.00 | $28.18 | $89.13 |
United Setting Professional Modifier None Typical Low $11.75 Median $19.95 Typical High $39.81 | Professional | None | $11.75 | $19.95 | $39.81 |
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 $13.18 Median $25.70 Typical High $35.48 | Facility | 52 · Reduced service | $13.18 | $25.70 | $35.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.25 Median $10.47 Typical High $14.13 | Facility | 53 · Discontinued | $5.25 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $13.18 Typical High $74.13 | Professional | 52 · Reduced service | $11.22 | $13.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.25 Typical High $29.51 | Professional | 53 · Discontinued | $4.47 | $5.25 | $29.51 |
Where Ohio sits
The same service costs 7.8 times more in Vermont than in Alabama. 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· 42nd of 51
$23.99
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.