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 $11.22 Median $26.30 Typical High $43.65 | Facility | None | $11.22 | $26.30 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $11.22 Typical High $91.20 | Professional | None | $9.55 | $11.22 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $18.62 | Professional | None | $6.03 | $6.03 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $13.80 Typical High $21.88 | Facility | None | $9.77 | $13.80 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $5.89 Typical High $10.47 | Professional | None | $4.79 | $5.89 | $10.47 |
Aultcare Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
CareSource Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $13.80 | Facility | None | $8.91 | $8.91 | $13.80 |
CareSource Setting Professional Modifier None Typical Low $7.76 Median $12.02 Typical High $16.22 | Professional | None | $7.76 | $12.02 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $14.45 Typical High $44.67 | Facility | None | $7.94 | $14.45 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $8.71 Typical High $21.38 | Professional | None | $6.17 | $8.71 | $21.38 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.72 Median $28.18 Typical High $97.72 | Facility | None | $10.72 | $28.18 | $97.72 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $21.38 | Professional | None | $6.17 | $7.76 | $21.38 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $8.91 Typical High $14.45 | Professional | None | $6.61 | $8.91 | $14.45 |
SummaCare Setting Professional Modifier None Typical Low $7.76 Median $10.23 Typical High $16.60 | Professional | None | $7.76 | $10.23 | $16.60 |
United Setting Facility Modifier None Typical Low $4.27 Median $10.72 Typical High $17.78 | Facility | None | $4.27 | $10.72 | $17.78 |
United Setting Professional Modifier None Typical Low $5.01 Median $8.32 Typical High $16.98 | Professional | None | $5.01 | $8.32 | $16.98 |
6 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 $5.62 Median $13.18 Typical High $21.88 | Facility | 52 · Reduced service | $5.62 | $13.18 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $5.25 Typical High $8.71 | Facility | 53 · Discontinued | $2.24 | $5.25 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $5.62 Typical High $75.86 | Professional | 52 · Reduced service | $4.79 | $5.62 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.24 Typical High $30.20 | Professional | 53 · Discontinued | $1.91 | $2.24 | $30.20 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $8.32 Median $13.80 Typical High $17.38 | Professional | QW · Waived lab test | $8.32 | $13.80 | $17.38 |
SummaCare Setting Professional Modifier QW · Waived lab test Typical Low $7.76 Median $10.23 Typical High $14.45 | Professional | QW · Waived lab test | $7.76 | $10.23 | $14.45 |
Where Ohio sits
The same service costs 5.5 times more in Vermont than in New Jersey. 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· 46th of 51
$9.77
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.