How much rates vary
Facilitymedian $25 · 10th to 90th $13 to $69Professionalmedian $10 · 10th to 90th $7 to $27
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 $14.13 Median $28.84 Typical High $51.29 | Facility | None | $14.13 | $28.84 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $19.95 Typical High $61.66 | Professional | None | $13.49 | $19.95 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $9.55 Typical High $10.23 | Professional | None | $8.13 | $9.55 | $10.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $19.50 Typical High $30.90 | Facility | None | $13.49 | $19.50 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $8.32 Typical High $15.49 | Professional | None | $6.76 | $8.32 | $15.49 |
Aultcare Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aultcare Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | None | $11.75 | $11.75 | $13.49 |
CareSource Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $19.50 | Facility | None | $16.98 | $16.98 | $19.50 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $16.98 Typical High $22.91 | Professional | None | $10.96 | $16.98 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $20.42 Typical High $36.31 | Facility | None | $11.75 | $20.42 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $30.20 | Professional | None | $8.51 | $11.48 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $11.48 Median $39.81 Typical High $100.00 | Facility | None | $11.48 | $39.81 | $100.00 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.90 Median $9.33 Typical High $22.91 | Professional | None | $4.90 | $9.33 | $22.91 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $19.95 | Professional | None | $9.33 | $12.59 | $19.95 |
SummaCare Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
SummaCare Setting Professional Modifier None Typical Low $12.59 Median $17.78 Typical High $30.20 | Professional | None | $12.59 | $17.78 | $30.20 |
United Setting Facility Modifier None Typical Low $5.89 Median $15.14 Typical High $60.26 | Facility | None | $5.89 | $15.14 | $60.26 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $23.99 | Professional | None | $7.08 | $10.23 | $23.99 |
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 $7.94 Median $15.49 Typical High $21.38 | Facility | 52 · Reduced service | $7.94 | $15.49 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $6.31 Typical High $8.51 | Facility | 53 · Discontinued | $3.16 | $6.31 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $7.94 Typical High $47.86 | Professional | 52 · Reduced service | $6.76 | $7.94 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.16 Typical High $19.05 | Professional | 53 · Discontinued | $2.69 | $3.16 | $19.05 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $11.48 Median $20.89 Typical High $24.55 | Professional | QW · Waived lab test | $11.48 | $20.89 | $24.55 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $10.96 Median $14.13 Typical High $19.95 | Professional | QW · Waived lab test | $10.96 | $14.13 | $19.95 |
Where Ohio sits
The same service costs 7.8 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· 47th of 51
$13.80
VT $105MD $13.49
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.