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 $30.90 Median $64.57 Typical High $104.71 | Facility | None | $30.90 | $64.57 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $26.30 Typical High $38.02 | Professional | None | $23.44 | $26.30 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $38.90 | Professional | None | $25.70 | $28.18 | $38.90 |
Aultcare Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $69.18 | Professional | None | $23.44 | $30.90 | $69.18 |
CareSource Setting Facility Modifier None Typical Low $26.30 Median $35.48 Typical High $35.48 | Facility | None | $26.30 | $35.48 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $41.69 | Professional | None | $24.55 | $30.90 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $39.81 | Professional | None | $25.12 | $38.90 | $39.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $38.90 | Professional | None | $22.91 | $22.91 | $38.90 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $44.67 | Professional | None | $25.12 | $30.20 | $44.67 |
Optum Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | None | $33.88 | $33.88 | $38.02 |
SummaCare Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $38.02 | Professional | None | $33.11 | $36.31 | $38.02 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Facility | None | $912.01 | $1,071.52 | $1,513.56 |
United Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $54.95 | Professional | None | $33.11 | $33.88 | $54.95 |
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 Facility Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $40.74 | Facility | 52 · Reduced service | $15.49 | $15.49 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $16.22 | Facility | 53 · Discontinued | $6.31 | $6.31 | $16.22 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $31.62 Median $31.62 Typical High $33.11 | Facility | AF · Specialist physician | $31.62 | $31.62 | $33.11 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $23.44 Median $23.44 Typical High $24.55 | Facility | HO · Master's level | $23.44 | $23.44 | $24.55 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $26.30 Median $26.30 Typical High $28.18 | Facility | TD · Registered nurse | $26.30 | $26.30 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.31 | $7.59 |
Where Ohio sits
The same service costs 2.1 times more in North Dakota than in Ohio. 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· 51st of 51
$26.30
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.