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 $5.13 Median $12.02 Typical High $23.99 | Facility | None | $5.13 | $12.02 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $7.24 Typical High $97.72 | Professional | None | $4.27 | $7.24 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $3.72 Median $8.32 Typical High $8.32 | Professional | None | $3.72 | $8.32 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.37 Median $6.31 Typical High $10.00 | Facility | None | $4.37 | $6.31 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.82 Typical High $6.76 | Professional | None | $2.63 | $2.82 | $6.76 |
Aultcare Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Aultcare Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
CareSource Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $6.17 | Facility | None | $3.72 | $3.72 | $6.17 |
CareSource Setting Professional Modifier None Typical Low $3.47 Median $5.37 Typical High $7.24 | Professional | None | $3.47 | $5.37 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $6.46 Typical High $19.95 | Facility | None | $3.55 | $6.46 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $3.47 Typical High $7.76 | Professional | None | $2.82 | $3.47 | $7.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.13 Median $19.95 Typical High $70.79 | Facility | None | $5.13 | $19.95 | $70.79 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.82 Median $3.55 Typical High $7.41 | Professional | None | $2.82 | $3.55 | $7.41 |
Molina Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $6.46 | Professional | None | $2.95 | $4.07 | $6.46 |
SummaCare Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $79.43 | Facility | None | $51.29 | $53.70 | $79.43 |
SummaCare Setting Professional Modifier None Typical Low $3.47 Median $4.57 Typical High $6.46 | Professional | None | $3.47 | $4.57 | $6.46 |
United Setting Facility Modifier None Typical Low $120.23 Median $141.25 Typical High $199.53 | Facility | None | $120.23 | $141.25 | $199.53 |
United Setting Professional Modifier None Typical Low $2.24 Median $3.80 Typical High $7.76 | Professional | None | $2.24 | $3.80 | $7.76 |
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 $2.51 Median $5.89 Typical High $16.98 | Facility | 52 · Reduced service | $2.51 | $5.89 | $16.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.02 Median $2.34 Typical High $6.76 | Facility | 53 · Discontinued | $1.02 | $2.34 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.51 Typical High $52.48 | Professional | 52 · Reduced service | $2.14 | $2.51 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.02 Typical High $21.38 | Professional | 53 · Discontinued | $0.85 | $1.02 | $21.38 |
Where Ohio sits
The same service costs 11.2 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· 43rd of 51
$4.57
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.