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 $0.14 Median $0.25 Typical High $0.47 | Facility | None | $0.14 | $0.25 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.18 Typical High $0.47 | Professional | None | $0.14 | $0.18 | $0.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.18 Median $0.40 Typical High $1.12 | Facility | None | $0.18 | $0.40 | $1.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.11 Median $0.14 Typical High $0.28 | Professional | None | $0.11 | $0.14 | $0.28 |
Aultcare Setting Facility Modifier None Typical Low $0.19 Median $0.19 Typical High $0.19 | Facility | None | $0.19 | $0.19 | $0.19 |
CareSource Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
CareSource Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Cigna Setting Facility Modifier None Typical Low $0.26 Median $0.30 Typical High $0.46 | Facility | None | $0.26 | $0.30 | $0.46 |
Cigna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.41 | Professional | None | $0.14 | $0.14 | $0.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $0.45 Median $1.66 Typical High $4.27 | Facility | None | $0.45 | $1.66 | $4.27 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.58 | Professional | None | $0.14 | $0.14 | $0.58 |
Molina Setting Professional Modifier None Typical Low $0.15 Median $0.20 Typical High $0.24 | Professional | None | $0.15 | $0.20 | $0.24 |
SummaCare Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $0.28 | Professional | None | $0.14 | $0.15 | $0.28 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.25 | Professional | None | $0.17 | $0.17 | $0.25 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.07 Median $0.07 Typical High $3.02 | Professional | 52 · Reduced service | $0.07 | $0.07 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $1.20 | Professional | 53 · Discontinued | $0.03 | $0.03 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.89 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.89 |
Where Ohio sits
The same service costs 4.4 times more in Michigan than in South Carolina. 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· 8th of 51
$0.23
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.