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 $12.02 Median $28.18 Typical High $46.77 | Facility | None | $12.02 | $28.18 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $16.22 Typical High $47.86 | Professional | None | $10.23 | $16.22 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.94 | Professional | None | $7.76 | $7.76 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $14.79 Typical High $23.44 | Facility | None | $10.47 | $14.79 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $6.76 Typical High $16.22 | Professional | None | $6.31 | $6.76 | $16.22 |
Aultcare Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aultcare Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
CareSource Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $14.79 | Facility | None | $10.23 | $10.23 | $14.79 |
CareSource Setting Professional Modifier None Typical Low $8.32 Median $12.88 Typical High $17.38 | Professional | None | $8.32 | $12.88 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $15.49 Typical High $38.02 | Facility | None | $8.91 | $15.49 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $6.61 Median $8.13 Typical High $18.62 | Professional | None | $6.61 | $8.13 | $18.62 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.80 Median $28.18 Typical High $85.11 | Facility | None | $13.80 | $28.18 | $85.11 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.61 Median $8.13 Typical High $17.78 | Professional | None | $6.61 | $8.13 | $17.78 |
Molina Setting Professional Modifier None Typical Low $7.08 Median $9.55 Typical High $15.49 | Professional | None | $7.08 | $9.55 | $15.49 |
SummaCare Setting Professional Modifier None Typical Low $8.32 Median $10.96 Typical High $25.70 | Professional | None | $8.32 | $10.96 | $25.70 |
United Setting Facility Modifier None Typical Low $4.68 Median $11.48 Typical High $19.50 | Facility | None | $4.68 | $11.48 | $19.50 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $18.62 | Professional | None | $5.37 | $7.94 | $18.62 |
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 $6.03 Median $14.13 Typical High $23.44 | Facility | 52 · Reduced service | $6.03 | $14.13 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.45 Median $5.62 Typical High $9.33 | Facility | 53 · Discontinued | $2.45 | $5.62 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $6.03 Typical High $42.66 | Professional | 52 · Reduced service | $5.13 | $6.03 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.45 Typical High $16.98 | Professional | 53 · Discontinued | $2.04 | $2.45 | $16.98 |
Where Ohio sits
The same service costs 13.5 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· 42nd 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.