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 $5.37 Median $12.88 Typical High $21.88 | Facility | None | $5.37 | $12.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $7.24 Typical High $22.39 | Professional | None | $4.79 | $7.24 | $22.39 |
Ambetter Setting Professional Modifier None Typical Low $2.69 Median $3.63 Typical High $9.33 | Professional | None | $2.69 | $3.63 | $9.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $6.92 Typical High $10.96 | Facility | None | $4.90 | $6.92 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.16 Typical High $7.76 | Professional | None | $2.95 | $3.16 | $7.76 |
Aultcare Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Aultcare Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $6.92 | Facility | None | $4.07 | $4.07 | $6.92 |
CareSource Setting Professional Modifier None Typical Low $3.89 Median $6.03 Typical High $8.13 | Professional | None | $3.89 | $6.03 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $7.24 Typical High $17.78 | Facility | None | $4.17 | $7.24 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $8.71 | Professional | None | $2.95 | $3.80 | $8.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.94 Median $28.18 Typical High $60.26 | Facility | None | $7.94 | $28.18 | $60.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.40 Median $3.80 Typical High $9.77 | Professional | None | $2.40 | $3.80 | $9.77 |
Molina Setting Professional Modifier None Typical Low $3.31 Median $4.47 Typical High $7.24 | Professional | None | $3.31 | $4.47 | $7.24 |
SummaCare Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $12.02 | Professional | None | $3.89 | $5.75 | $12.02 |
United Setting Facility Modifier None Typical Low $2.00 Median $5.37 Typical High $15.14 | Facility | None | $2.00 | $5.37 | $15.14 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.72 Typical High $8.51 | Professional | None | $2.51 | $3.72 | $8.51 |
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 $2.82 Median $6.61 Typical High $10.96 | Facility | 52 · Reduced service | $2.82 | $6.61 | $10.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.12 Median $2.63 Typical High $4.37 | Facility | 53 · Discontinued | $1.12 | $2.63 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.40 Median $2.82 Typical High $33.88 | Professional | 52 · Reduced service | $2.40 | $2.82 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.12 Typical High $13.49 | Professional | 53 · Discontinued | $0.95 | $1.12 | $13.49 |
Where Ohio sits
The same service costs 14.5 times more in Minnesota 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· 37th 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.