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 $3.55 Median $7.94 Typical High $13.18 | Facility | None | $3.55 | $7.94 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $4.27 Typical High $19.95 | Professional | None | $2.88 | $4.27 | $19.95 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.88 Median $4.17 Typical High $6.61 | Facility | None | $2.88 | $4.17 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.31 | Professional | None | $1.78 | $1.78 | $3.31 |
CareSource Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $4.07 | Facility | None | $1.95 | $1.95 | $4.07 |
CareSource Setting Professional Modifier None Typical Low $2.34 Median $3.55 Typical High $4.79 | Professional | None | $2.34 | $3.55 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $4.27 Typical High $15.14 | Facility | None | $2.34 | $4.27 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $2.29 Typical High $6.31 | Professional | None | $1.82 | $2.29 | $6.31 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $3.72 Median $5.89 Typical High $19.95 | Facility | None | $3.72 | $5.89 | $19.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.45 Median $2.34 Typical High $6.03 | Professional | None | $1.45 | $2.34 | $6.03 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $4.27 | Professional | None | $1.95 | $2.69 | $4.27 |
SummaCare Setting Professional Modifier None Typical Low $2.34 Median $3.02 Typical High $5.13 | Professional | None | $2.34 | $3.02 | $5.13 |
United Setting Facility Modifier None Typical Low $1.29 Median $3.24 Typical High $5.37 | Facility | None | $1.29 | $3.24 | $5.37 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.55 Typical High $5.13 | Professional | None | $2.14 | $3.55 | $5.13 |
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 $1.70 Median $3.39 Typical High $11.48 | Facility | 52 · Reduced service | $1.70 | $3.39 | $11.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.68 Median $1.38 Typical High $4.57 | Facility | 53 · Discontinued | $0.68 | $1.38 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.70 Typical High $11.48 | Professional | 52 · Reduced service | $1.45 | $1.70 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.68 Typical High $4.57 | Professional | 53 · Discontinued | $0.56 | $0.68 | $4.57 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $4.47 Typical High $5.75 | Professional | QW · Waived lab test | $2.45 | $4.47 | $5.75 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $2.34 Median $3.02 Typical High $4.27 | Professional | QW · Waived lab test | $2.34 | $3.02 | $4.27 |
Where Ohio sits
The same service costs 3.5 times more in Kansas than in Tennessee. 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· 46th of 51
$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.