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 $11.22 Median $22.91 Typical High $43.65 | Facility | None | $11.22 | $22.91 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $14.45 Typical High $47.86 | Professional | None | $9.77 | $14.45 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $6.31 Median $7.24 Typical High $18.62 | Professional | None | $6.31 | $7.24 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $14.13 Typical High $22.39 | Facility | None | $9.77 | $14.13 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.31 Typical High $15.14 | Professional | None | $6.03 | $6.31 | $15.14 |
Aultcare Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aultcare Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
CareSource Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $13.80 | Facility | None | $12.02 | $12.02 | $13.80 |
CareSource Setting Professional Modifier None Typical Low $7.94 Median $12.02 Typical High $16.22 | Professional | None | $7.94 | $12.02 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $14.45 Typical High $26.30 | Facility | None | $7.94 | $14.45 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $16.98 | Professional | None | $6.17 | $7.76 | $16.98 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $12.02 Median $26.30 Typical High $120.23 | Facility | None | $12.02 | $26.30 | $120.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3.89 Median $7.76 Typical High $17.78 | Professional | None | $3.89 | $7.76 | $17.78 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $14.45 | Professional | None | $6.61 | $9.12 | $14.45 |
SummaCare Setting Professional Modifier None Typical Low $7.94 Median $11.48 Typical High $21.88 | Professional | None | $7.94 | $11.48 | $21.88 |
United Setting Facility Modifier None Typical Low $4.37 Median $10.96 Typical High $18.20 | Facility | None | $4.37 | $10.96 | $18.20 |
United Setting Professional Modifier None Typical Low $5.13 Median $7.41 Typical High $17.38 | Professional | None | $5.13 | $7.41 | $17.38 |
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 $5.75 Median $11.48 Typical High $21.88 | Facility | 52 · Reduced service | $5.75 | $11.48 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.29 Median $4.57 Typical High $8.71 | Facility | 53 · Discontinued | $2.29 | $4.57 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $5.75 Typical High $48.98 | Professional | 52 · Reduced service | $4.79 | $5.75 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.29 Typical High $19.50 | Professional | 53 · Discontinued | $1.95 | $2.29 | $19.50 |
Where Ohio sits
The same service costs 8.3 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· 40th of 51
$10.72
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.