How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $15Professionalmedian $3 · 10th to 90th $2 to $7
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 $3.63 Median $7.59 Typical High $12.02 | Facility | None | $3.63 | $7.59 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $4.68 Typical High $15.14 | Professional | None | $3.16 | $4.68 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $6.03 | Professional | None | $1.95 | $1.95 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.16 Median $4.57 Typical High $7.24 | Facility | None | $3.16 | $4.57 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $4.27 | Professional | None | $1.95 | $1.95 | $4.27 |
Aultcare Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Facility | None | $2.69 | $2.69 | $2.69 |
Aultcare Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $3.16 | Professional | None | $2.75 | $2.75 | $3.16 |
CareSource Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $4.47 | Facility | None | $2.69 | $2.69 | $4.47 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $3.89 Typical High $5.37 | Professional | None | $2.51 | $3.89 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $4.68 Typical High $8.51 | Facility | None | $2.57 | $4.68 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.63 Typical High $6.76 | Professional | None | $2.00 | $2.63 | $6.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.17 Median $8.91 Typical High $26.92 | Facility | None | $4.17 | $8.91 | $26.92 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.79 Median $2.00 Typical High $6.76 | Professional | None | $0.79 | $2.00 | $6.76 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.95 Typical High $4.68 | Professional | None | $2.14 | $2.95 | $4.68 |
SummaCare Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $8.51 | Professional | None | $2.95 | $3.72 | $8.51 |
United Setting Facility Modifier None Typical Low $1.41 Median $3.89 Typical High $10.47 | Facility | None | $1.41 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.89 Typical High $5.62 | Professional | None | $2.34 | $3.89 | $5.62 |
7 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 $1.86 Median $3.72 Typical High $5.01 | Facility | 52 · Reduced service | $1.86 | $3.72 | $5.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.74 Median $1.51 Typical High $2.00 | Facility | 53 · Discontinued | $0.74 | $1.51 | $2.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.86 Typical High $10.47 | Professional | 52 · Reduced service | $1.58 | $1.86 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.74 Typical High $4.17 | Professional | 53 · Discontinued | $0.63 | $0.74 | $4.17 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.66 Median $2.00 Typical High $3.31 | Professional | QW · Waived lab test | $1.66 | $2.00 | $3.31 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $4.90 Typical High $6.31 | Professional | QW · Waived lab test | $2.69 | $4.90 | $6.31 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $2.57 Median $3.31 Typical High $4.68 | Professional | QW · Waived lab test | $2.57 | $3.31 | $4.68 |
Where Ohio sits
The same service costs 12.6 times more in Vermont than in Washington, DC. 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· 48th of 51
$3.72
VT $39.81DC $3.16
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.