How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $12Professionalmedian $2 · 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 $3.72 Median $8.51 Typical High $14.45 | Facility | None | $3.72 | $8.51 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.98 Typical High $26.92 | Professional | None | $3.16 | $3.98 | $26.92 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $6.03 | Professional | None | $2.34 | $2.34 | $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 $1.51 Median $1.91 Typical High $3.31 | Professional | None | $1.51 | $1.91 | $3.31 |
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 $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $4.47 | Facility | None | $2.63 | $2.63 | $4.47 |
CareSource Setting Professional Modifier None Typical Low $2.51 Median $3.89 Typical High $5.25 | Professional | None | $2.51 | $3.89 | $5.25 |
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 $2.63 Median $5.13 Typical High $34.67 | Facility | None | $2.63 | $5.13 | $34.67 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.70 Median $2.19 Typical High $6.76 | Professional | None | $1.70 | $2.19 | $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 $2.57 Median $3.31 Typical High $7.76 | Professional | None | $2.57 | $3.31 | $7.76 |
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 $2.09 Median $3.89 Typical High $5.50 | Professional | None | $2.09 | $3.89 | $5.50 |
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 $1.86 Median $3.72 Typical High $9.33 | Facility | 52 · Reduced service | $1.86 | $3.72 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.74 Median $1.51 Typical High $3.72 | Facility | 53 · Discontinued | $0.74 | $1.51 | $3.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.58 Median $1.66 Typical High $22.39 | Professional | 52 · Reduced service | $1.58 | $1.66 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.66 Typical High $8.91 | Professional | 53 · Discontinued | $0.63 | $0.66 | $8.91 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $4.47 Typical High $5.75 | Professional | QW · Waived lab test | $2.69 | $4.47 | $5.75 |
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 8.1 times more in Vermont than in New Jersey. 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· 47th of 51
$3.31
VT $22.39NJ $2.75
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.