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 $147.91 Median $363.08 Typical High $524.81 | Facility | None | $147.91 | $363.08 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $204.17 | Professional | None | $109.65 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $79.43 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $177.83 Typical High $208.93 | Professional | None | $120.23 | $177.83 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $165.96 | Professional | None | $97.72 | $117.49 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $257.04 | Professional | None | $154.88 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $295.12 | Professional | None | $112.20 | $165.96 | $295.12 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $295.12 | Professional | None | $112.20 | $165.96 | $295.12 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $316.23 | Professional | None | $158.49 | $218.78 | $316.23 |
SummaCare Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $218.78 | Professional | None | $125.89 | $154.88 | $218.78 |
United Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $457.09 | Facility | None | $275.42 | $316.23 | $457.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $302.00 | Professional | None | $112.20 | $169.82 | $302.00 |
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 $208.93 Median $208.93 Typical High $251.19 | Professional | 25 · Same-day visit | $208.93 | $208.93 | $251.19 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | GC · Resident with teaching physician | $120.23 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $177.83 Median $177.83 Typical High $251.19 | Professional | SA · Nurse practitioner | $177.83 | $177.83 | $251.19 |
Where Ohio sits
The same service costs 2.8 times more in Alaska 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· 37th of 51
$158
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.