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 $4.27 Median $8.71 Typical High $14.45 | Facility | None | $4.27 | $8.71 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $5.62 Typical High $17.38 | Professional | None | $3.80 | $5.62 | $17.38 |
Ambetter Setting Professional Modifier None Typical Low $1.29 Median $2.82 Typical High $4.79 | Professional | None | $1.29 | $2.82 | $4.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $5.50 Typical High $8.71 | Facility | None | $3.80 | $5.50 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $2.51 Typical High $6.03 | Professional | None | $2.34 | $2.51 | $6.03 |
Aultcare Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Aultcare Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.80 | Professional | None | $3.31 | $3.31 | $3.80 |
CareSource Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.50 | Facility | None | $4.79 | $4.79 | $5.50 |
CareSource Setting Professional Modifier None Typical Low $3.09 Median $4.79 Typical High $6.46 | Professional | None | $3.09 | $4.79 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $5.75 Typical High $13.80 | Facility | None | $3.09 | $5.75 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.02 Typical High $6.92 | Professional | None | $2.45 | $3.02 | $6.92 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.25 Median $17.78 Typical High $48.98 | Facility | None | $5.25 | $17.78 | $48.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.82 Median $3.02 Typical High $6.61 | Professional | None | $1.82 | $3.02 | $6.61 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $3.55 Typical High $5.75 | Professional | None | $2.63 | $3.55 | $5.75 |
SummaCare Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $8.51 | Professional | None | $3.09 | $4.47 | $8.51 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.27 Typical High $10.47 | Facility | None | $1.38 | $4.27 | $10.47 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.88 Typical High $6.76 | Professional | None | $2.00 | $2.88 | $6.76 |
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 $2.24 Median $4.57 Typical High $6.03 | Facility | 52 · Reduced service | $2.24 | $4.57 | $6.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.89 Median $1.82 Typical High $2.40 | Facility | 53 · Discontinued | $0.89 | $1.82 | $2.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.91 Median $2.24 Typical High $25.70 | Professional | 52 · Reduced service | $1.91 | $2.24 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.89 Typical High $10.47 | Professional | 53 · Discontinued | $0.76 | $0.89 | $10.47 |
Where Ohio sits
The same service costs 11.7 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· 41st of 51
$4.37
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.