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 $5.89 Median $12.88 Typical High $19.50 | Facility | None | $5.89 | $12.88 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $19.50 | Professional | None | $4.68 | $5.75 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $9.12 | Professional | None | $5.25 | $5.25 | $9.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.68 Median $6.76 Typical High $10.72 | Facility | None | $4.68 | $6.76 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $5.50 Typical High $8.51 | Professional | None | $3.98 | $5.50 | $8.51 |
CareSource Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $6.76 | Facility | None | $4.37 | $4.37 | $6.76 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $7.94 | Professional | None | $3.80 | $5.75 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $6.17 Typical High $12.59 | Facility | None | $3.80 | $6.17 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $7.76 | Professional | None | $2.63 | $3.80 | $7.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $5.62 Median $12.30 Typical High $46.77 | Facility | None | $5.62 | $12.30 | $46.77 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.63 Median $3.80 Typical High $7.76 | Professional | None | $2.63 | $3.80 | $7.76 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $4.37 Typical High $6.92 | Professional | None | $3.24 | $4.37 | $6.92 |
SummaCare Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $6.92 | Professional | None | $3.80 | $4.90 | $6.92 |
United Setting Facility Modifier None Typical Low $2.09 Median $5.75 Typical High $12.02 | Facility | None | $2.09 | $5.75 | $12.02 |
United Setting Professional Modifier None Typical Low $3.16 Median $5.01 Typical High $6.92 | Professional | None | $3.16 | $5.01 | $6.92 |
7 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 $2.75 Median $5.62 Typical High $10.47 | Facility | 52 · Reduced service | $2.75 | $5.62 | $10.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.10 Median $2.24 Typical High $4.27 | Facility | 53 · Discontinued | $1.10 | $2.24 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $2.75 Typical High $11.48 | Professional | 52 · Reduced service | $2.34 | $2.75 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.10 Typical High $4.57 | Professional | 53 · Discontinued | $0.93 | $1.10 | $4.57 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $2.88 Typical High $2.95 | Professional | QW · Waived lab test | $2.45 | $2.88 | $2.95 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.98 Median $6.46 Typical High $8.51 | Professional | QW · Waived lab test | $3.98 | $6.46 | $8.51 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $3.80 Median $4.90 Typical High $6.92 | Professional | QW · Waived lab test | $3.80 | $4.90 | $6.92 |
Where Ohio sits
The same service costs 7.9 times more in Minnesota than in New York. 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· 30th of 51
$5.75
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.