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 $3.98 Median $9.33 Typical High $15.49 | Facility | None | $3.98 | $9.33 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $15.85 | Professional | None | $3.39 | $5.13 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $1.15 Median $2.14 Typical High $6.61 | Professional | None | $1.15 | $2.14 | $6.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $7.94 | Facility | None | $3.47 | $4.90 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.24 Typical High $5.37 | Professional | None | $2.09 | $2.24 | $5.37 |
Aultcare Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
Aultcare Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
CareSource Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.90 | Facility | None | $4.27 | $4.27 | $4.90 |
CareSource Setting Professional Modifier None Typical Low $2.75 Median $4.27 Typical High $5.75 | Professional | None | $2.75 | $4.27 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.13 Typical High $12.30 | Facility | None | $2.95 | $5.13 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $6.17 | Professional | None | $2.14 | $2.69 | $6.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.47 Median $10.72 Typical High $32.36 | Facility | None | $4.47 | $10.72 | $32.36 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.55 Median $2.29 Typical High $5.01 | Professional | None | $1.55 | $2.29 | $5.01 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $3.02 Typical High $5.13 | Professional | None | $2.34 | $3.02 | $5.13 |
SummaCare Setting Professional Modifier None Typical Low $2.75 Median $3.63 Typical High $8.51 | Professional | None | $2.75 | $3.63 | $8.51 |
United Setting Facility Modifier None Typical Low $1.55 Median $4.27 Typical High $8.91 | Facility | None | $1.55 | $4.27 | $8.91 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.63 Typical High $6.17 | Professional | None | $1.78 | $2.63 | $6.17 |
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 $2.04 Median $4.68 Typical High $7.76 | Facility | 52 · Reduced service | $2.04 | $4.68 | $7.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.81 Median $1.86 Typical High $3.09 | Facility | 53 · Discontinued | $0.81 | $1.86 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $2.04 Typical High $19.95 | Professional | 52 · Reduced service | $1.70 | $2.04 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.81 Typical High $7.94 | Professional | 53 · Discontinued | $0.68 | $0.81 | $7.94 |
Where Ohio sits
The same service costs 15.1 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· 48th of 51
$3.47
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.