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 $10.72 Median $19.95 Typical High $32.36 | Facility | None | $10.72 | $19.95 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $53.70 | Professional | None | $9.33 | $12.59 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $13.49 Typical High $21.38 | Facility | None | $9.33 | $13.49 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.25 Typical High $9.55 | Professional | None | $4.27 | $5.25 | $9.55 |
Aultcare Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
CareSource Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $13.18 | Facility | None | $7.94 | $7.94 | $13.18 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $11.48 Typical High $15.49 | Professional | None | $7.59 | $11.48 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $13.80 Typical High $25.12 | Facility | None | $7.59 | $13.80 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $6.76 Typical High $16.60 | Professional | None | $5.50 | $6.76 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $14.13 Median $42.66 Typical High $100.00 | Facility | None | $14.13 | $42.66 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.37 Median $6.76 Typical High $14.79 | Professional | None | $4.37 | $6.76 | $14.79 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $8.71 Typical High $13.80 | Professional | None | $6.31 | $8.71 | $13.80 |
SummaCare Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $13.80 | Professional | None | $7.59 | $9.77 | $13.80 |
United Setting Facility Modifier None Typical Low $4.17 Median $11.48 Typical High $44.67 | Facility | None | $4.17 | $11.48 | $44.67 |
United Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $16.22 | Professional | None | $4.90 | $7.08 | $16.22 |
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 $5.50 Median $10.72 Typical High $14.45 | Facility | 52 · Reduced service | $5.50 | $10.72 | $14.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.19 Median $4.27 Typical High $5.89 | Facility | 53 · Discontinued | $2.19 | $4.27 | $5.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $5.50 Typical High $38.90 | Professional | 52 · Reduced service | $4.68 | $5.50 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.19 Typical High $15.49 | Professional | 53 · Discontinued | $1.86 | $2.19 | $15.49 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $7.94 Median $14.45 Typical High $16.98 | Professional | QW · Waived lab test | $7.94 | $14.45 | $16.98 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $7.59 Median $9.77 Typical High $13.80 | Professional | QW · Waived lab test | $7.59 | $9.77 | $13.80 |
Where Ohio sits
The same service costs 13.2 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· 38th of 51
$10.96
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.