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 $2.14 Median $2.14 Typical High $2.88 | Facility | None | $2.14 | $2.14 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $2.29 Typical High $2.88 | Professional | None | $1.95 | $2.29 | $2.88 |
Ambetter Setting Professional Modifier None Typical Low $2.24 Median $2.82 Typical High $3.02 | Professional | None | $2.24 | $2.82 | $3.02 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.82 Median $2.24 Typical High $2.95 | Professional | QW · Waived lab test | $1.82 | $2.24 | $2.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.70 Median $2.51 Typical High $4.68 | Facility | None | $1.70 | $2.51 | $4.68 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.24 | Professional | None | $1.70 | $1.70 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.78 Typical High $3.09 | Professional | None | $1.41 | $1.78 | $3.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.24 Median $9.12 Typical High $45.71 | Facility | None | $2.24 | $9.12 | $45.71 |
Health Alliance Plan Setting Facility Modifier QW · Waived lab test Typical Low $2.24 Median $18.20 Typical High $263.03 | Facility | QW · Waived lab test | $2.24 | $18.20 | $263.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $4.68 | Professional | None | $2.04 | $2.69 | $4.68 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $2.24 Median $2.69 Typical High $5.37 | Professional | QW · Waived lab test | $2.24 | $2.69 | $5.37 |
Priority Health Setting Professional Modifier None Typical Low $1.41 Median $1.74 Typical High $2.88 | Professional | None | $1.41 | $1.74 | $2.88 |
United Setting Facility Modifier None Typical Low $1.35 Median $2.04 Typical High $2.69 | Facility | None | $1.35 | $2.04 | $2.69 |
United Setting Professional Modifier None Typical Low $1.35 Median $3.09 Typical High $3.24 | Professional | None | $1.35 | $3.09 | $3.24 |
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 $1.07 Median $1.07 Typical High $1.66 | Facility | 52 · Reduced service | $1.07 | $1.07 | $1.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.68 | Facility | 53 · Discontinued | $0.43 | $0.43 | $0.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $1.07 Typical High $1.12 | Professional | 52 · Reduced service | $0.95 | $1.07 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.43 Typical High $0.45 | Professional | 53 · Discontinued | $0.38 | $0.43 | $0.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.43 |
Where Michigan sits
The same service costs 20.4 times more in Vermont 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· 19th of 51
$2.75
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.