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 $9.77 Median $16.60 Typical High $30.90 | Facility | None | $9.77 | $16.60 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $66.07 | Professional | None | $9.12 | $10.00 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | None | $7.08 | $7.08 | $7.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $13.49 Typical High $21.38 | Facility | None | $9.33 | $13.49 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $13.18 | Professional | None | $4.57 | $4.90 | $13.18 |
Aultcare Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Aultcare Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $13.18 | Facility | None | $11.48 | $11.48 | $13.18 |
CareSource Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $15.49 | Professional | None | $7.41 | $11.48 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $13.18 Typical High $25.12 | Facility | None | $7.94 | $13.18 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $5.37 Median $6.31 Typical High $16.60 | Professional | None | $5.37 | $6.31 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $7.41 Median $21.38 Typical High $54.95 | Facility | None | $7.41 | $21.38 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $13.80 | Professional | None | $4.57 | $6.03 | $13.80 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $8.13 Typical High $13.80 | Professional | None | $6.31 | $8.13 | $13.80 |
SummaCare Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $19.05 | Professional | None | $7.41 | $9.77 | $19.05 |
United Setting Facility Modifier None Typical Low $4.17 Median $10.47 Typical High $17.38 | Facility | None | $4.17 | $10.47 | $17.38 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $16.60 | Professional | None | $4.79 | $6.92 | $16.60 |
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 $4.57 Median $8.32 Typical High $13.80 | Facility | 52 · Reduced service | $4.57 | $8.32 | $13.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.82 Median $3.31 Typical High $5.50 | Facility | 53 · Discontinued | $1.82 | $3.31 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.57 Typical High $38.90 | Professional | 52 · Reduced service | $4.57 | $4.57 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $15.49 | Professional | 53 · Discontinued | $1.82 | $1.82 | $15.49 |
Where Ohio sits
The same service costs 24.0 times more in Vermont than in New Jersey. 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· 41st of 51
$9.12
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.