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 $27.54 Typical High $44.67 | Facility | None | $13.80 | $27.54 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $74.13 | Professional | None | $11.75 | $17.38 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $10.23 | Professional | None | $7.76 | $8.91 | $10.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $16.98 Typical High $26.92 | Facility | None | $12.02 | $16.98 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $7.76 Typical High $18.62 | Professional | None | $7.24 | $7.76 | $18.62 |
Aultcare Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aultcare Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | None | $10.23 | $10.23 | $11.75 |
CareSource Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $16.98 | Facility | None | $14.79 | $14.79 | $16.98 |
CareSource Setting Professional Modifier None Typical Low $9.55 Median $14.79 Typical High $19.95 | Professional | None | $9.55 | $14.79 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $17.78 Typical High $32.36 | Facility | None | $10.23 | $17.78 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $21.38 | Professional | None | $7.41 | $9.33 | $21.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.41 Median $19.50 Typical High $56.23 | Facility | None | $7.41 | $19.50 | $56.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.62 Median $7.94 Typical High $20.42 | Professional | None | $1.62 | $7.94 | $20.42 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $10.96 Typical High $17.78 | Professional | None | $8.13 | $10.96 | $17.78 |
SummaCare Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
SummaCare Setting Professional Modifier None Typical Low $9.55 Median $14.13 Typical High $26.30 | Professional | None | $9.55 | $14.13 | $26.30 |
United Setting Facility Modifier None Typical Low $5.25 Median $14.79 Typical High $44.67 | Facility | None | $5.25 | $14.79 | $44.67 |
United Setting Professional Modifier None Typical Low $6.17 Median $9.12 Typical High $20.89 | Professional | None | $6.17 | $9.12 | $20.89 |
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 $6.92 Median $13.49 Typical High $18.62 | Facility | 52 · Reduced service | $6.92 | $13.49 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.75 Median $5.50 Typical High $7.41 | Facility | 53 · Discontinued | $2.75 | $5.50 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $6.92 Typical High $38.02 | Professional | 52 · Reduced service | $5.89 | $6.92 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $2.75 Typical High $15.14 | Professional | 53 · Discontinued | $2.34 | $2.75 | $15.14 |
Where Ohio sits
The same service costs 7.9 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
$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.