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 $14.45 Median $46.77 Typical High $158.49 | Facility | None | $14.45 | $46.77 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $46.77 Typical High $83.18 | Professional | None | $11.75 | $46.77 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $15.49 Typical High $21.38 | Professional | None | $10.96 | $15.49 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $18.62 | Professional | None | $12.02 | $12.30 | $18.62 |
Aultcare Setting Professional Modifier None Typical Low $10.96 Median $15.14 Typical High $47.86 | Professional | None | $10.96 | $15.14 | $47.86 |
CareSource Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $60.26 | Professional | None | $37.15 | $44.67 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $74.13 | Professional | None | $12.02 | $45.71 | $74.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $380.19 | Facility | None | $128.82 | $229.09 | $380.19 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $11.48 Median $33.11 Typical High $67.61 | Professional | None | $11.48 | $33.11 | $67.61 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $54.95 | Professional | None | $25.70 | $38.02 | $54.95 |
SummaCare Setting Professional Modifier None Typical Low $11.48 Median $25.12 Typical High $72.44 | Professional | None | $11.48 | $25.12 | $72.44 |
United Setting Professional Modifier None Typical Low $10.96 Median $36.31 Typical High $75.86 | Professional | None | $10.96 | $36.31 | $75.86 |
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 Professional Modifier 53 · Discontinued Typical Low $2.34 Median $9.33 Typical High $9.77 | Professional | 53 · Discontinued | $2.34 | $9.33 | $9.77 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $10.00 Median $10.00 Typical High $14.13 | Professional | 59 · Distinct service | $10.00 | $10.00 | $14.13 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 76 · Repeat, same provider | $23.44 | $23.44 | $23.44 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $10.96 Median $13.49 Typical High $14.13 | Professional | GC · Resident with teaching physician | $10.96 | $13.49 | $14.13 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | XU · Unusual separate service | $10.96 | $10.96 | $10.96 |
Where Ohio sits
The same service costs 6.8 times more in Minnesota than in Georgia. 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· 40th of 51
$24.55
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.