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 $13.18 Median $30.20 Typical High $50.12 | Facility | None | $13.18 | $30.20 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $42.66 | Professional | None | $10.96 | $18.20 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $15.85 Typical High $25.12 | Facility | None | $11.22 | $15.85 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $7.24 Typical High $17.38 | Professional | None | $6.76 | $7.24 | $17.38 |
Aultcare Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
CareSource Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $15.85 | Facility | None | $10.96 | $10.96 | $15.85 |
CareSource Setting Professional Modifier None Typical Low $8.91 Median $13.80 Typical High $18.62 | Professional | None | $8.91 | $13.80 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $16.60 Typical High $31.62 | Facility | None | $8.91 | $16.60 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $8.71 Typical High $19.50 | Professional | None | $6.92 | $8.71 | $19.50 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $14.45 Median $21.38 Typical High $56.23 | Facility | None | $14.45 | $21.38 | $56.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.92 Median $8.51 Typical High $19.05 | Professional | None | $6.92 | $8.51 | $19.05 |
Molina Setting Professional Modifier None Typical Low $7.59 Median $10.23 Typical High $16.60 | Professional | None | $7.59 | $10.23 | $16.60 |
SummaCare Setting Professional Modifier None Typical Low $8.91 Median $11.75 Typical High $18.62 | Professional | None | $8.91 | $11.75 | $18.62 |
United Setting Facility Modifier None Typical Low $4.90 Median $12.30 Typical High $20.42 | Facility | None | $4.90 | $12.30 | $20.42 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $19.50 | Professional | None | $5.75 | $8.32 | $19.50 |
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 $6.46 Median $13.49 Typical High $22.39 | Facility | 52 · Reduced service | $6.46 | $13.49 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.57 Median $5.37 Typical High $8.91 | Facility | 53 · Discontinued | $2.57 | $5.37 | $8.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $6.46 Typical High $21.38 | Professional | 52 · Reduced service | $5.50 | $6.46 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.57 Typical High $8.51 | Professional | 53 · Discontinued | $2.19 | $2.57 | $8.51 |
Where Ohio sits
The same service costs 3.0 times more in Alaska 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· 43rd of 51
$11.48
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.