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 $1.62 Median $2.14 Typical High $6.76 | Facility | None | $1.62 | $2.14 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $2.14 | Professional | None | $1.62 | $1.82 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.45 Median $1.66 Typical High $2.24 | Professional | None | $1.45 | $1.66 | $2.24 |
Aultcare Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
CareSource Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $2.29 | Facility | None | $1.82 | $1.82 | $2.29 |
CareSource Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $5.01 Typical High $5.01 | Professional | None | $2.00 | $5.01 | $5.01 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $5.01 | Professional | None | $0.83 | $0.83 | $5.01 |
Molina Setting Professional Modifier None Typical Low $1.51 Median $1.78 Typical High $1.78 | Professional | None | $1.51 | $1.78 | $1.78 |
Optum Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
SummaCare Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $2.29 | Professional | None | $2.04 | $2.29 | $2.29 |
United Setting Facility Modifier None Typical Low $58.88 Median $69.18 Typical High $97.72 | Facility | None | $58.88 | $69.18 | $97.72 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.34 Typical High $3.24 | Professional | None | $1.91 | $2.34 | $3.24 |
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 $1.07 Median $1.07 Typical High $13.49 | Facility | 52 · Reduced service | $1.07 | $1.07 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $5.37 | Facility | 53 · Discontinued | $0.43 | $0.43 | $5.37 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $2.14 Median $2.14 Typical High $2.29 | Facility | AF · Specialist physician | $2.14 | $2.14 | $2.29 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $1.62 Median $1.62 Typical High $1.70 | Facility | HO · Master's level | $1.62 | $1.62 | $1.70 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $1.82 Median $1.82 Typical High $1.95 | Facility | TD · Registered nurse | $1.82 | $1.82 | $1.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.07 Typical High $1.12 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.46 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.46 |
Where Ohio sits
The same service costs 2.2 times more in North Dakota than in Kentucky. 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· 48th of 51
$1.82
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.