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 $8.32 Median $19.50 Typical High $32.36 | Facility | None | $8.32 | $19.50 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $9.33 Typical High $41.69 | Professional | None | $7.08 | $9.33 | $41.69 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $8.91 | Professional | None | $5.50 | $5.50 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.24 Median $10.23 Typical High $16.22 | Facility | None | $7.24 | $10.23 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.68 Typical High $11.22 | Professional | None | $4.37 | $4.68 | $11.22 |
Aultcare Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aultcare Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
CareSource Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $10.23 | Facility | None | $6.76 | $6.76 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $5.75 Median $8.91 Typical High $12.02 | Professional | None | $5.75 | $8.91 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $10.72 Typical High $26.30 | Facility | None | $5.89 | $10.72 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $5.62 Typical High $12.88 | Professional | None | $4.47 | $5.62 | $12.88 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.03 Median $18.62 Typical High $57.54 | Facility | None | $6.03 | $18.62 | $57.54 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $4.47 Median $5.75 Typical High $14.79 | Professional | None | $4.47 | $5.75 | $14.79 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $6.61 Typical High $10.72 | Professional | None | $4.90 | $6.61 | $10.72 |
SummaCare Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $17.78 | Professional | None | $5.75 | $7.59 | $17.78 |
United Setting Facility Modifier None Typical Low $3.24 Median $8.91 Typical High $36.31 | Facility | None | $3.24 | $8.91 | $36.31 |
United Setting Professional Modifier None Typical Low $3.72 Median $6.17 Typical High $12.59 | Professional | None | $3.72 | $6.17 | $12.59 |
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 $4.17 Median $9.77 Typical High $16.22 | Facility | 52 · Reduced service | $4.17 | $9.77 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.70 Median $3.89 Typical High $6.46 | Facility | 53 · Discontinued | $1.70 | $3.89 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $4.17 Typical High $28.18 | Professional | 52 · Reduced service | $3.55 | $4.17 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.70 Typical High $11.22 | Professional | 53 · Discontinued | $1.41 | $1.70 | $11.22 |
Where Ohio sits
The same service costs 8.7 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· 45th of 51
$7.41
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.