How much rates vary
Facilitymedian $21 · 10th to 90th $12 to $51Professionalmedian $9 · 10th to 90th $6 to $23
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 $24.55 Typical High $51.29 | Facility | None | $13.18 | $24.55 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $16.98 Typical High $52.48 | Professional | None | $11.48 | $16.98 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $8.51 Typical High $14.45 | Professional | None | $3.89 | $8.51 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $16.60 Typical High $26.30 | Facility | None | $11.48 | $16.60 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $6.61 Typical High $11.75 | Professional | None | $5.25 | $6.61 | $11.75 |
Aultcare Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aultcare Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $16.60 | Facility | None | $14.13 | $14.13 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $19.05 | Professional | None | $9.33 | $14.13 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $16.98 Typical High $30.90 | Facility | None | $9.77 | $16.98 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $9.12 Typical High $19.95 | Professional | None | $7.24 | $9.12 | $19.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $13.18 Median $28.84 Typical High $114.82 | Facility | None | $13.18 | $28.84 | $114.82 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $5.37 Median $8.91 Typical High $15.85 | Professional | None | $5.37 | $8.91 | $15.85 |
Molina Setting Professional Modifier None Typical Low $7.76 Median $10.72 Typical High $16.98 | Professional | None | $7.76 | $10.72 | $16.98 |
SummaCare Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
SummaCare Setting Professional Modifier None Typical Low $9.33 Median $13.49 Typical High $25.70 | Professional | None | $9.33 | $13.49 | $25.70 |
United Setting Facility Modifier None Typical Low $5.13 Median $12.88 Typical High $21.38 | Facility | None | $5.13 | $12.88 | $21.38 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $19.95 | Professional | None | $6.03 | $8.51 | $19.95 |
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 $6.76 Median $13.80 Typical High $25.70 | Facility | 52 · Reduced service | $6.76 | $13.80 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.69 Median $5.50 Typical High $10.47 | Facility | 53 · Discontinued | $2.69 | $5.50 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $6.76 Typical High $57.54 | Professional | 52 · Reduced service | $5.75 | $6.76 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.69 Typical High $22.91 | Professional | 53 · Discontinued | $2.29 | $2.69 | $22.91 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $9.77 Median $17.78 Typical High $20.89 | Professional | QW · Waived lab test | $9.77 | $17.78 | $20.89 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $9.33 Median $12.02 Typical High $16.98 | Professional | QW · Waived lab test | $9.33 | $12.02 | $16.98 |
Where Ohio sits
The same service costs 9.5 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· 48th of 51
$11.48
VT $107IN $11.22
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.