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 $8.51 Median $23.99 Typical High $28.84 | Facility | None | $8.51 | $23.99 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $9.33 Typical High $33.11 | Professional | None | $8.51 | $9.33 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $8.32 Typical High $12.59 | Professional | None | $7.59 | $8.32 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $13.18 | Professional | None | $7.59 | $8.91 | $13.18 |
Aultcare Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $16.60 | Professional | None | $7.41 | $10.72 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $8.13 Typical High $12.30 | Professional | None | $7.59 | $8.13 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $10.96 Typical High $16.60 | Professional | None | $7.76 | $10.96 | $16.60 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.72 Median $28.18 Typical High $40.74 | Professional | None | $10.72 | $28.18 | $40.74 |
Molina Setting Professional Modifier None Typical Low $7.41 Median $7.94 Typical High $8.71 | Professional | None | $7.41 | $7.94 | $8.71 |
SummaCare Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $13.49 | Professional | None | $7.76 | $8.91 | $13.49 |
United Setting Professional Modifier None Typical Low $6.92 Median $8.51 Typical High $20.42 | Professional | None | $6.92 | $8.51 | $20.42 |
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 Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $26.92 | Professional | 52 · Reduced service | $4.27 | $4.27 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $10.72 | Professional | 53 · Discontinued | $1.74 | $1.74 | $10.72 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $8.13 Median $10.23 Typical High $10.23 | Professional | 59 · Distinct service | $8.13 | $10.23 | $10.23 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $8.13 Median $10.96 Typical High $16.98 | Professional | 76 · Repeat, same provider | $8.13 | $10.96 | $16.98 |
Ambetter Setting Professional Modifier 77 · Repeat, other provider Typical Low $7.59 Median $9.33 Typical High $16.98 | Professional | 77 · Repeat, other provider | $7.59 | $9.33 | $16.98 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $6.46 Median $14.79 Typical High $14.79 | Professional | GC · Resident with teaching physician | $6.46 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $6.92 Median $6.92 Typical High $11.48 | Professional | SA · Nurse practitioner | $6.92 | $6.92 | $11.48 |
Where Ohio sits
The same service costs 2.5 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· 23rd of 51
$10.96
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.