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 $3.02 Median $3.02 Typical High $4.07 | Facility | None | $3.02 | $3.02 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $4.07 | Professional | None | $2.69 | $3.24 | $4.07 |
Ambetter Setting Professional Modifier None Typical Low $2.40 Median $3.16 Typical High $4.27 | Professional | None | $2.40 | $3.16 | $4.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.40 Median $3.55 Typical High $6.61 | Facility | None | $2.40 | $3.55 | $6.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $3.47 | Professional | None | $3.02 | $3.16 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.57 Typical High $4.68 | Professional | None | $2.04 | $2.57 | $4.68 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.16 Median $18.20 Typical High $57.54 | Facility | None | $3.16 | $18.20 | $57.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.82 Median $3.80 Typical High $6.61 | Professional | None | $2.82 | $3.80 | $6.61 |
Priority Health Setting Professional Modifier None Typical Low $2.04 Median $3.16 Typical High $4.07 | Professional | None | $2.04 | $3.16 | $4.07 |
United Setting Facility Modifier None Typical Low $1.12 Median $2.82 Typical High $3.80 | Facility | None | $1.12 | $2.82 | $3.80 |
United Setting Professional Modifier None Typical Low $1.91 Median $4.27 Typical High $4.57 | Professional | None | $1.91 | $4.27 | $4.57 |
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 $1.51 Median $1.51 Typical High $2.34 | Facility | 52 · Reduced service | $1.51 | $1.51 | $2.34 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.93 | Facility | 53 · Discontinued | $0.60 | $0.60 | $0.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.35 Median $1.51 Typical High $1.58 | Professional | 52 · Reduced service | $1.35 | $1.51 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.62 Typical High $0.65 | Professional | 53 · Discontinued | $0.54 | $0.62 | $0.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.60 |
Where Michigan sits
The same service costs 22.4 times more in Minnesota than in Washington, DC. 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· 18th of 51
$4.17
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.