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 $19.95 Median $33.11 Typical High $46.77 | Facility | None | $19.95 | $33.11 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $23.44 Typical High $36.31 | Professional | None | $17.78 | $23.44 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $37.15 | Professional | None | $25.70 | $30.90 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $39.81 | Professional | None | $26.92 | $31.62 | $39.81 |
Aultcare Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $52.48 | Professional | None | $30.20 | $34.67 | $52.48 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $46.77 | Professional | None | $28.84 | $30.90 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $50.12 | Professional | None | $28.84 | $30.90 | $50.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $23.44 Median $35.48 Typical High $66.07 | Professional | None | $23.44 | $35.48 | $66.07 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $38.90 | Professional | None | $21.38 | $30.20 | $38.90 |
Optum Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | None | $26.30 | $30.90 | $30.90 |
SummaCare Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $33.11 | Professional | None | $27.54 | $32.36 | $33.11 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $45.71 | Professional | None | $26.30 | $33.11 | $45.71 |
6 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 $11.75 Median $12.02 Typical High $15.85 | Facility | 52 · Reduced service | $11.75 | $12.02 | $15.85 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $23.44 Median $23.99 Typical High $25.12 | Facility | AF · Specialist physician | $23.44 | $23.99 | $25.12 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $17.78 Median $18.20 Typical High $19.05 | Facility | HO · Master's level | $17.78 | $18.20 | $19.05 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $19.95 Median $20.42 Typical High $21.38 | Facility | TD · Registered nurse | $19.95 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $12.02 Typical High $15.14 | Professional | 52 · Reduced service | $11.75 | $12.02 | $15.14 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $21.88 Median $26.30 Typical High $26.30 | Professional | SA · Nurse practitioner | $21.88 | $26.30 | $26.30 |
Where Ohio sits
The same service costs 2.5 times more in Alaska than in New York. 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· 30th of 51
$30.90
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.