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 $12.59 Median $12.88 Typical High $19.95 | Facility | None | $12.59 | $12.88 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $17.38 | Professional | None | $11.48 | $13.49 | $17.38 |
Ambetter Setting Professional Modifier None Typical Low $6.76 Median $10.72 Typical High $10.72 | Professional | None | $6.76 | $10.72 | $10.72 |
BCBS Michigan Setting Facility Modifier None Typical Low $11.48 Median $16.60 Typical High $28.84 | Facility | None | $11.48 | $16.60 | $28.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | None | $11.48 | $11.48 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $19.05 | Professional | None | $10.00 | $13.80 | $19.05 |
Health Alliance Plan Setting Facility Modifier None Typical Low $12.88 Median $51.29 Typical High $169.82 | Facility | None | $12.88 | $51.29 | $169.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $10.00 Median $15.49 Typical High $28.18 | Professional | None | $10.00 | $15.49 | $28.18 |
Priority Health Setting Professional Modifier None Typical Low $10.00 Median $12.30 Typical High $16.60 | Professional | None | $10.00 | $12.30 | $16.60 |
United Setting Facility Modifier None Typical Low $3.63 Median $12.02 Typical High $16.22 | Facility | None | $3.63 | $12.02 | $16.22 |
United Setting Professional Modifier None Typical Low $5.62 Median $10.47 Typical High $17.38 | Professional | None | $5.62 | $10.47 | $17.38 |
8 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 $6.31 Median $6.31 Typical High $10.00 | Facility | 52 · Reduced service | $6.31 | $6.31 | $10.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $3.98 | Facility | 53 · Discontinued | $2.51 | $2.51 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $6.46 Typical High $6.76 | Professional | 52 · Reduced service | $5.75 | $6.46 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.57 Typical High $2.69 | Professional | 53 · Discontinued | $2.29 | $2.57 | $2.69 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $6.31 Median $6.31 Typical High $10.00 | Facility | 52 · Reduced service | $6.31 | $6.31 | $10.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $13.49 Median $15.85 Typical High $24.55 | Professional | QW · Waived lab test | $13.49 | $15.85 | $24.55 |
Where Michigan sits
The same service costs 10.7 times more in Vermont than in Maryland. 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.
Michigan· 17th of 51
$16.60
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.