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 $6.46 Median $14.79 Typical High $20.89 | Facility | None | $6.46 | $14.79 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $7.24 Typical High $25.70 | Professional | None | $5.50 | $7.24 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $10.72 | Professional | None | $3.47 | $3.47 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $7.94 Typical High $12.59 | Facility | None | $5.62 | $7.94 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.63 Typical High $8.71 | Professional | None | $3.39 | $3.63 | $8.71 |
Aultcare Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aultcare Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.50 | Professional | None | $4.79 | $4.79 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.94 | Facility | None | $6.92 | $6.92 | $7.94 |
CareSource Setting Professional Modifier None Typical Low $4.47 Median $6.92 Typical High $9.33 | Professional | None | $4.47 | $6.92 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $8.32 Typical High $15.14 | Facility | None | $4.79 | $8.32 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $4.47 Typical High $9.77 | Professional | None | $3.47 | $4.47 | $9.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.24 Median $9.12 Typical High $41.69 | Facility | None | $7.24 | $9.12 | $41.69 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.47 Median $4.37 Typical High $11.48 | Professional | None | $3.47 | $4.37 | $11.48 |
Molina Setting Professional Modifier None Typical Low $3.80 Median $4.79 Typical High $8.32 | Professional | None | $3.80 | $4.79 | $8.32 |
SummaCare Setting Professional Modifier None Typical Low $4.47 Median $5.89 Typical High $13.80 | Professional | None | $4.47 | $5.89 | $13.80 |
United Setting Facility Modifier None Typical Low $2.45 Median $6.17 Typical High $10.23 | Facility | None | $2.45 | $6.17 | $10.23 |
United Setting Professional Modifier None Typical Low $2.88 Median $4.17 Typical High $9.77 | Professional | None | $2.88 | $4.17 | $9.77 |
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 $3.24 Median $6.61 Typical High $9.77 | Facility | 52 · Reduced service | $3.24 | $6.61 | $9.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.29 Median $2.63 Typical High $3.89 | Facility | 53 · Discontinued | $1.29 | $2.63 | $3.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $3.24 Typical High $30.20 | Professional | 52 · Reduced service | $2.75 | $3.24 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.29 Typical High $12.02 | Professional | 53 · Discontinued | $1.10 | $1.29 | $12.02 |
Where Ohio sits
The same service costs 13.5 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· 43rd of 51
$5.75
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.