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 $8.13 Median $8.32 Typical High $12.88 | Facility | None | $8.13 | $8.32 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $8.51 Typical High $10.96 | Professional | None | $6.46 | $8.51 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $8.71 Typical High $11.75 | Professional | None | $6.92 | $8.71 | $11.75 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.46 Median $9.55 Typical High $16.22 | Facility | None | $6.46 | $9.55 | $16.22 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $8.71 | Professional | None | $6.46 | $6.46 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $8.71 Typical High $12.30 | Professional | None | $4.07 | $8.71 | $12.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.13 Median $24.55 Typical High $72.44 | Facility | None | $8.13 | $24.55 | $72.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $6.46 Median $8.71 Typical High $16.60 | Professional | None | $6.46 | $8.71 | $16.60 |
Priority Health Setting Professional Modifier None Typical Low $4.07 Median $8.71 Typical High $10.23 | Professional | None | $4.07 | $8.71 | $10.23 |
United Setting Facility Modifier None Typical Low $5.13 Median $7.76 Typical High $10.23 | Facility | None | $5.13 | $7.76 | $10.23 |
United Setting Professional Modifier None Typical Low $4.57 Median $8.71 Typical High $9.55 | Professional | None | $4.57 | $8.71 | $9.55 |
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 $4.07 Median $4.07 Typical High $6.31 | Facility | 52 · Reduced service | $4.07 | $4.07 | $6.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $2.51 | Facility | 53 · Discontinued | $1.62 | $1.62 | $2.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $4.17 Typical High $4.37 | Professional | 52 · Reduced service | $3.63 | $4.17 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.66 Typical High $1.74 | Professional | 53 · Discontinued | $1.45 | $1.66 | $1.74 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $7.24 Median $8.71 Typical High $8.71 | Professional | QW · Waived lab test | $7.24 | $8.71 | $8.71 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $6.31 | Facility | 52 · Reduced service | $4.07 | $4.07 | $6.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $3.89 | $4.07 | $4.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Where Michigan sits
The same service costs 15.8 times more in Minnesota than in Alabama. 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· 26th of 51
$8.71
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.