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 $11.48 Median $25.70 Typical High $40.74 | Facility | None | $11.48 | $25.70 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $11.48 Typical High $22.39 | Professional | None | $9.33 | $11.48 | $22.39 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $19.05 | Professional | None | $12.59 | $14.79 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $15.85 | Professional | None | $9.77 | $11.48 | $15.85 |
Aultcare Setting Professional Modifier None Typical Low $11.48 Median $16.22 Typical High $19.05 | Professional | None | $11.48 | $16.22 | $19.05 |
CareSource Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $20.89 | Professional | None | $13.18 | $14.45 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $19.05 | Professional | None | $11.22 | $13.49 | $19.05 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $10.96 Median $13.49 Typical High $18.20 | Professional | None | $10.96 | $13.49 | $18.20 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $9.33 Typical High $10.96 | Professional | None | $7.24 | $9.33 | $10.96 |
SummaCare Setting Professional Modifier None Typical Low $10.96 Median $12.59 Typical High $18.20 | Professional | None | $10.96 | $12.59 | $18.20 |
United Setting Facility Modifier None Typical Low $77.62 Median $89.13 Typical High $128.82 | Facility | None | $77.62 | $89.13 | $128.82 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.02 Typical High $18.62 | Professional | None | $9.77 | $12.02 | $18.62 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $8.91 Median $12.59 Typical High $14.79 | Professional | 25 · Same-day visit | $8.91 | $12.59 | $14.79 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $10.47 Median $14.79 Typical High $15.49 | Professional | GC · Resident with teaching physician | $10.47 | $14.79 | $15.49 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | SA · Nurse practitioner | $10.72 | $10.72 | $10.72 |
Where Ohio sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 45th of 51
$12.30
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.