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 $4.27 Median $10.23 Typical High $15.49 | Facility | None | $4.27 | $10.23 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $15.85 | Professional | None | $3.39 | $5.13 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $6.46 | Professional | None | $1.82 | $1.82 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $7.94 | Facility | None | $3.47 | $4.90 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $5.50 Typical High $7.94 | Professional | None | $2.95 | $5.50 | $7.94 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $4.90 | Facility | None | $3.24 | $3.24 | $4.90 |
CareSource Setting Professional Modifier None Typical Low $2.75 Median $4.27 Typical High $5.75 | Professional | None | $2.75 | $4.27 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $5.13 Typical High $12.59 | Facility | None | $2.82 | $5.13 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $7.76 | Professional | None | $2.14 | $2.69 | $7.76 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2.88 Median $5.62 Typical High $16.98 | Facility | None | $2.88 | $5.62 | $16.98 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.14 Median $2.69 Typical High $7.76 | Professional | None | $2.14 | $2.69 | $7.76 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $3.24 Typical High $5.13 | Professional | None | $2.34 | $3.24 | $5.13 |
SummaCare Setting Professional Modifier None Typical Low $2.75 Median $3.63 Typical High $5.13 | Professional | None | $2.75 | $3.63 | $5.13 |
United Setting Facility Modifier None Typical Low $1.55 Median $3.80 Typical High $6.46 | Facility | None | $1.55 | $3.80 | $6.46 |
United Setting Professional Modifier None Typical Low $2.57 Median $4.27 Typical High $6.17 | Professional | None | $2.57 | $4.27 | $6.17 |
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 $2.04 Median $4.68 Typical High $7.76 | Facility | 52 · Reduced service | $2.04 | $4.68 | $7.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.81 Median $1.86 Typical High $3.09 | Facility | 53 · Discontinued | $0.81 | $1.86 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $2.04 Typical High $12.88 | Professional | 52 · Reduced service | $1.70 | $2.04 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.81 Typical High $5.25 | Professional | 53 · Discontinued | $0.68 | $0.81 | $5.25 |
Where Ohio sits
The same service costs 3.2 times more in Kansas 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· 13th of 51
$5.50
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.