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 $25.12 Median $58.88 Typical High $97.72 | Facility | None | $25.12 | $58.88 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $97.72 | Professional | None | $21.38 | $21.38 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $11.22 Median $13.18 Typical High $15.85 | Professional | None | $11.22 | $13.18 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $30.90 Typical High $48.98 | Facility | None | $21.38 | $30.90 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $43.65 | Professional | None | $15.14 | $15.14 | $43.65 |
Aultcare Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
CareSource Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $34.67 Typical High $109.65 | Facility | None | $25.70 | $34.67 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $46.77 | Professional | None | $13.49 | $13.49 | $46.77 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $28.18 Median $66.07 Typical High $123.03 | Facility | None | $28.18 | $66.07 | $123.03 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $43.65 | Professional | None | $13.49 | $14.45 | $43.65 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $21.88 Typical High $25.70 | Professional | None | $10.96 | $21.88 | $25.70 |
SummaCare Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $51.29 | Professional | None | $22.39 | $32.36 | $51.29 |
United Setting Facility Modifier None Typical Low $9.55 Median $23.99 Typical High $39.81 | Facility | None | $9.55 | $23.99 | $39.81 |
United Setting Professional Modifier None Typical Low $15.85 Median $26.92 Typical High $43.65 | Professional | None | $15.85 | $26.92 | $43.65 |
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 $12.59 Median $29.51 Typical High $47.86 | Facility | 52 · Reduced service | $12.59 | $29.51 | $47.86 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $11.75 Typical High $19.50 | Facility | 53 · Discontinued | $5.01 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $10.72 Typical High $48.98 | Professional | 52 · Reduced service | $10.72 | $10.72 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $19.95 | Professional | 53 · Discontinued | $4.27 | $4.27 | $19.95 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 59 · Distinct service | $13.18 | $13.18 | $13.18 |
Where Ohio sits
The same service costs 4.5 times more in Alaska 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· 37th of 51
$27.54
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.