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 $0.05 Median $0.09 Typical High $0.36 | Facility | None | $0.05 | $0.09 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $2.00 | Professional | None | $0.05 | $0.05 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.05 Median $0.12 Typical High $0.33 | Facility | None | $0.05 | $0.12 | $0.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.10 | Professional | None | $0.05 | $0.05 | $0.10 |
Aultcare Setting Facility Modifier None Typical Low $0.07 Median $0.07 Typical High $0.07 | Facility | None | $0.07 | $0.07 | $0.07 |
CareSource Setting Facility Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Facility | None | $0.06 | $0.06 | $0.06 |
CareSource Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | None | $0.08 | $0.08 | $0.08 |
Cigna Setting Facility Modifier None Typical Low $0.10 Median $0.11 Typical High $0.18 | Facility | None | $0.10 | $0.11 | $0.18 |
Cigna Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.13 | Professional | None | $0.05 | $0.05 | $0.13 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.10 Median $0.15 Typical High $0.81 | Facility | None | $0.10 | $0.15 | $0.81 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.13 | Professional | None | $0.05 | $0.05 | $0.13 |
Molina Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.08 | Professional | None | $0.06 | $0.07 | $0.08 |
SummaCare Setting Professional Modifier None Typical Low $0.05 Median $0.06 Typical High $0.10 | Professional | None | $0.05 | $0.06 | $0.10 |
United Setting Professional Modifier None Typical Low $0.05 Median $0.05 Typical High $0.07 | Professional | None | $0.05 | $0.05 | $0.07 |
1 more rate 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 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $1.51 | Professional | 52 · Reduced service | $0.03 | $0.03 | $1.51 |
Where Ohio sits
The same service costs 12.9 times more in Oklahoma than in Delaware. 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· 15th of 51
$0.06
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.