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 $12.30 Typical High $18.62 | Facility | None | $5.13 | $12.30 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $38.90 | Professional | None | $4.17 | $6.03 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $7.94 | Professional | None | $2.57 | $2.57 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $6.03 Typical High $9.55 | Facility | None | $4.17 | $6.03 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.69 Typical High $6.61 | Professional | None | $2.57 | $2.69 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $6.03 | Facility | None | $5.13 | $5.13 | $6.03 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $6.92 | Professional | None | $3.39 | $5.13 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $6.17 Typical High $14.79 | Facility | None | $3.39 | $6.17 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $3.31 Typical High $7.24 | Professional | None | $2.63 | $3.31 | $7.24 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.37 Median $12.59 Typical High $45.71 | Facility | None | $5.37 | $12.59 | $45.71 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.63 Median $3.31 Typical High $7.24 | Professional | None | $2.63 | $3.31 | $7.24 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $6.17 | Professional | None | $2.82 | $3.89 | $6.17 |
SummaCare Setting Professional Modifier None Typical Low $3.39 Median $4.37 Typical High $10.00 | Professional | None | $3.39 | $4.37 | $10.00 |
United Setting Facility Modifier None Typical Low $1.86 Median $5.13 Typical High $8.91 | Facility | None | $1.86 | $5.13 | $8.91 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $7.24 | Professional | None | $2.19 | $3.16 | $7.24 |
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 $2.45 Median $5.75 Typical High $9.33 | Facility | 52 · Reduced service | $2.45 | $5.75 | $9.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.98 Median $2.29 Typical High $3.80 | Facility | 53 · Discontinued | $0.98 | $2.29 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.45 Typical High $21.88 | Professional | 52 · Reduced service | $2.04 | $2.45 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.98 Typical High $8.71 | Professional | 53 · Discontinued | $0.83 | $0.98 | $8.71 |
Where Ohio sits
The same service costs 9.3 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· 47th of 51
$4.17
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.