How much rates vary
Facilitymedian $25 · 10th to 90th $14 to $58Professionalmedian $10 · 10th to 90th $8 to $31
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 $16.22 Median $37.15 Typical High $61.66 | Facility | None | $16.22 | $37.15 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $18.62 Typical High $63.10 | Professional | None | $13.49 | $18.62 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $26.30 | Professional | None | $10.23 | $10.23 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $19.95 Typical High $31.62 | Facility | None | $13.80 | $19.95 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $15.85 | Professional | None | $8.32 | $8.32 | $15.85 |
Aultcare Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aultcare Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
CareSource Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $19.50 | Facility | None | $12.59 | $12.59 | $19.50 |
CareSource Setting Professional Modifier None Typical Low $10.96 Median $16.98 Typical High $22.91 | Professional | None | $10.96 | $16.98 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $20.42 Typical High $57.54 | Facility | None | $11.22 | $20.42 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $24.55 | Professional | None | $8.51 | $10.96 | $24.55 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $11.48 Median $38.02 Typical High $112.20 | Facility | None | $11.48 | $38.02 | $112.20 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.31 Median $8.51 Typical High $23.44 | Professional | None | $6.31 | $8.51 | $23.44 |
Molina Setting Professional Modifier None Typical Low $9.33 Median $12.88 Typical High $20.42 | Professional | None | $9.33 | $12.88 | $20.42 |
SummaCare Setting Professional Modifier None Typical Low $10.96 Median $14.45 Typical High $28.18 | Professional | None | $10.96 | $14.45 | $28.18 |
United Setting Facility Modifier None Typical Low $6.17 Median $15.49 Typical High $25.70 | Facility | None | $6.17 | $15.49 | $25.70 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.47 Typical High $24.55 | Professional | None | $7.08 | $10.47 | $24.55 |
6 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 $7.94 Median $18.62 Typical High $30.90 | Facility | 52 · Reduced service | $7.94 | $18.62 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.24 Median $7.41 Typical High $12.30 | Facility | 53 · Discontinued | $3.24 | $7.41 | $12.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $7.94 Typical High $70.79 | Professional | 52 · Reduced service | $6.76 | $7.94 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.24 Typical High $28.18 | Professional | 53 · Discontinued | $2.69 | $3.24 | $28.18 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $11.75 Median $19.50 Typical High $25.12 | Professional | QW · Waived lab test | $11.75 | $19.50 | $25.12 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $10.96 Median $14.45 Typical High $20.42 | Professional | QW · Waived lab test | $10.96 | $14.45 | $20.42 |
Where Ohio sits
The same service costs 8.1 times more in Vermont than in Indiana. 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· 44th of 51
$14.13
VT $105IN $12.88
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.