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 $20.42 Median $44.67 Typical High $74.13 | Facility | None | $20.42 | $44.67 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $75.86 | Professional | None | $16.22 | $16.22 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $10.23 | Professional | None | $8.71 | $10.23 | $10.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $23.44 Typical High $37.15 | Facility | None | $16.60 | $23.44 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $34.67 | Professional | None | $11.48 | $11.48 | $34.67 |
Aultcare Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
CareSource Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $27.54 | Professional | None | $20.42 | $20.42 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $26.30 Typical High $83.18 | Facility | None | $19.95 | $26.30 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $35.48 | Professional | None | $10.23 | $10.23 | $35.48 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $21.88 Median $54.95 Typical High $117.49 | Facility | None | $21.88 | $54.95 | $117.49 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $33.88 | Professional | None | $10.23 | $10.23 | $33.88 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $16.60 Typical High $19.95 | Professional | None | $8.32 | $16.60 | $19.95 |
SummaCare Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $44.67 | Professional | None | $17.38 | $25.12 | $44.67 |
United Setting Facility Modifier None Typical Low $7.24 Median $18.20 Typical High $30.20 | Facility | None | $7.24 | $18.20 | $30.20 |
United Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $34.67 | Professional | None | $12.02 | $20.42 | $34.67 |
5 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 $9.55 Median $22.39 Typical High $37.15 | Facility | 52 · Reduced service | $9.55 | $22.39 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.80 Median $8.91 Typical High $14.79 | Facility | 53 · Discontinued | $3.80 | $8.91 | $14.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $37.15 | Professional | 52 · Reduced service | $8.13 | $8.13 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $15.14 | Professional | 53 · Discontinued | $3.24 | $3.24 | $15.14 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 90 · Outside lab | $7.24 | $7.24 | $7.24 |
Where Ohio sits
The same service costs 4.6 times more in Vermont than in Illinois. 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· 39th of 51
$20.42
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.