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 $2.75 Median $6.61 Typical High $13.18 | Facility | None | $2.75 | $6.61 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $3.55 Typical High $21.38 | Professional | None | $2.40 | $3.55 | $21.38 |
Ambetter Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $4.68 | Professional | None | $1.78 | $1.78 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $3.47 Typical High $5.50 | Facility | None | $2.40 | $3.47 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.48 Median $1.58 Typical High $4.07 | Professional | None | $1.48 | $1.58 | $4.07 |
Aultcare Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Aultcare Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
CareSource Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.47 | Facility | None | $3.02 | $3.02 | $3.47 |
CareSource Setting Professional Modifier None Typical Low $1.95 Median $3.02 Typical High $4.07 | Professional | None | $1.95 | $3.02 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $3.63 Typical High $12.59 | Facility | None | $2.04 | $3.63 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.91 Typical High $4.17 | Professional | None | $1.48 | $1.91 | $4.17 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $4.27 Median $25.12 Typical High $60.26 | Facility | None | $4.27 | $25.12 | $60.26 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1.48 Median $2.00 Typical High $4.17 | Professional | None | $1.48 | $2.00 | $4.17 |
Molina Setting Professional Modifier None Typical Low $1.62 Median $2.09 Typical High $3.55 | Professional | None | $1.62 | $2.09 | $3.55 |
SummaCare Setting Facility Modifier None Typical Low $6.46 Median $32.36 Typical High $50.12 | Facility | None | $6.46 | $32.36 | $50.12 |
SummaCare Setting Professional Modifier None Typical Low $1.95 Median $2.51 Typical High $5.89 | Professional | None | $1.95 | $2.51 | $5.89 |
United Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $125.89 | Facility | None | $77.62 | $89.13 | $125.89 |
United Setting Professional Modifier None Typical Low $1.26 Median $2.14 Typical High $4.37 | Professional | None | $1.26 | $2.14 | $4.37 |
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 $1.41 Median $3.31 Typical High $10.72 | Facility | 52 · Reduced service | $1.41 | $3.31 | $10.72 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.56 Median $1.32 Typical High $4.27 | Facility | 53 · Discontinued | $0.56 | $1.32 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.20 Median $1.41 Typical High $30.90 | Professional | 52 · Reduced service | $1.20 | $1.41 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.48 Median $0.56 Typical High $12.30 | Professional | 53 · Discontinued | $0.48 | $0.56 | $12.30 |
Where Ohio sits
The same service costs 28.2 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· 38th of 51
$2.88
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.