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 $9.33 Median $22.39 Typical High $37.15 | Facility | None | $9.33 | $22.39 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $12.02 Typical High $41.69 | Professional | None | $8.13 | $12.02 | $41.69 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $6.17 Typical High $15.85 | Professional | None | $5.37 | $6.17 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.32 Median $11.75 Typical High $18.62 | Facility | None | $8.32 | $11.75 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $5.37 Typical High $12.88 | Professional | None | $5.01 | $5.37 | $12.88 |
Aultcare Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
Aultcare Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
CareSource Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $11.75 | Facility | None | $6.92 | $6.92 | $11.75 |
CareSource Setting Professional Modifier None Typical Low $6.61 Median $10.23 Typical High $13.80 | Professional | None | $6.61 | $10.23 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $12.30 Typical High $22.39 | Facility | None | $6.76 | $12.30 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $6.46 Typical High $14.45 | Professional | None | $5.13 | $6.46 | $14.45 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.18 Median $67.61 Typical High $138.04 | Facility | None | $13.18 | $67.61 | $138.04 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.07 Median $6.46 Typical High $14.13 | Professional | None | $4.07 | $6.46 | $14.13 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $7.59 Typical High $12.30 | Professional | None | $5.62 | $7.59 | $12.30 |
SummaCare Setting Professional Modifier None Typical Low $6.61 Median $8.71 Typical High $20.42 | Professional | None | $6.61 | $8.71 | $20.42 |
United Setting Facility Modifier None Typical Low $3.63 Median $9.12 Typical High $15.14 | Facility | None | $3.63 | $9.12 | $15.14 |
United Setting Professional Modifier None Typical Low $4.27 Median $6.31 Typical High $14.45 | Professional | None | $4.27 | $6.31 | $14.45 |
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 $4.79 Median $11.22 Typical High $18.62 | Facility | 52 · Reduced service | $4.79 | $11.22 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.91 Median $4.47 Typical High $7.41 | Facility | 53 · Discontinued | $1.91 | $4.47 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.79 Typical High $74.13 | Professional | 52 · Reduced service | $4.07 | $4.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.91 Typical High $29.51 | Professional | 53 · Discontinued | $1.62 | $1.91 | $29.51 |
Where Ohio sits
The same service costs 26.9 times more in Vermont than in Alabama. 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· 37th of 51
$9.55
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.