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 $10.23 Median $20.42 Typical High $36.31 | Facility | None | $10.23 | $20.42 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $12.59 Typical High $39.81 | Professional | None | $8.51 | $12.59 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $16.60 | Professional | None | $6.46 | $6.46 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $12.59 Typical High $19.95 | Facility | None | $8.71 | $12.59 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $13.80 | Professional | None | $5.25 | $5.62 | $13.80 |
Aultcare Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | None | $7.24 | $7.24 | $7.24 |
Aultcare Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
CareSource Setting Facility Modifier None Typical Low $7.08 Median $10.00 Typical High $12.30 | Facility | None | $7.08 | $10.00 | $12.30 |
CareSource Setting Professional Modifier None Typical Low $6.92 Median $10.72 Typical High $14.45 | Professional | None | $6.92 | $10.72 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $12.88 Typical High $39.81 | Facility | None | $7.08 | $12.88 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $34.67 | Professional | None | $13.49 | $15.49 | $34.67 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $11.22 Median $26.92 Typical High $120.23 | Facility | None | $11.22 | $26.92 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.61 Median $14.79 Typical High $33.11 | Professional | None | $6.61 | $14.79 | $33.11 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $8.91 Typical High $16.22 | Professional | None | $5.89 | $8.91 | $16.22 |
SummaCare Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $12.88 | Professional | None | $6.92 | $9.12 | $12.88 |
United Setting Facility Modifier None Typical Low $3.89 Median $10.72 Typical High $30.20 | Facility | None | $3.89 | $10.72 | $30.20 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.61 Typical High $15.49 | Professional | None | $4.47 | $6.61 | $15.49 |
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 $5.13 Median $10.23 Typical High $18.20 | Facility | 52 · Reduced service | $5.13 | $10.23 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.04 Median $4.07 Typical High $7.24 | Facility | 53 · Discontinued | $2.04 | $4.07 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $5.13 Typical High $36.31 | Professional | 52 · Reduced service | $4.27 | $5.13 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.04 Typical High $14.45 | Professional | 53 · Discontinued | $1.74 | $2.04 | $14.45 |
Where Ohio sits
The same service costs 7.9 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· 39th 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.