How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $11Professionalmedian $2 · 10th to 90th $1 to $4
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 $2.19 Median $5.25 Typical High $8.71 | Facility | None | $2.19 | $5.25 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $8.91 | Professional | None | $1.91 | $2.82 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $3.63 | Professional | None | $1.20 | $1.20 | $3.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.91 Median $2.75 Typical High $4.37 | Facility | None | $1.91 | $2.75 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.95 Median $1.12 Typical High $2.04 | Professional | None | $0.95 | $1.12 | $2.04 |
Aultcare Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
Aultcare Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
CareSource Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.75 | Facility | None | $2.34 | $2.34 | $2.75 |
CareSource Setting Professional Modifier None Typical Low $1.55 Median $2.34 Typical High $3.24 | Professional | None | $1.55 | $2.34 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.51 Typical High $5.13 | Facility | None | $1.55 | $2.51 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $1.15 Median $1.66 Typical High $4.37 | Professional | None | $1.15 | $1.66 | $4.37 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.51 Median $7.94 Typical High $26.92 | Facility | None | $2.51 | $7.94 | $26.92 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.95 Median $1.66 Typical High $4.37 | Professional | None | $0.95 | $1.66 | $4.37 |
Molina Setting Professional Modifier None Typical Low $1.29 Median $1.78 Typical High $2.82 | Professional | None | $1.29 | $1.78 | $2.82 |
SummaCare Setting Professional Modifier None Typical Low $1.55 Median $2.00 Typical High $4.68 | Professional | None | $1.55 | $2.00 | $4.68 |
United Setting Facility Modifier None Typical Low $0.85 Median $2.34 Typical High $7.59 | Facility | None | $0.85 | $2.34 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.34 Typical High $3.39 | Professional | None | $1.41 | $2.34 | $3.39 |
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 $1.12 Median $2.63 Typical High $4.27 | Facility | 52 · Reduced service | $1.12 | $2.63 | $4.27 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.45 Median $1.05 Typical High $1.74 | Facility | 53 · Discontinued | $0.45 | $1.05 | $1.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $1.12 Typical High $5.50 | Professional | 52 · Reduced service | $0.95 | $1.12 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.45 Typical High $2.19 | Professional | 53 · Discontinued | $0.38 | $0.45 | $2.19 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $1.62 Median $3.02 Typical High $3.80 | Professional | QW · Waived lab test | $1.62 | $3.02 | $3.80 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $1.55 Median $2.00 Typical High $2.82 | Professional | QW · Waived lab test | $1.55 | $2.00 | $2.82 |
Where Ohio sits
The same service costs 17.0 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· 46th of 51
$2.19
VT $32.36MD $1.91
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.