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 $5.50 Median $5.50 Typical High $7.41 | Facility | None | $5.50 | $5.50 | $7.41 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $4.27 | Facility | 52 · Reduced service | $2.75 | $2.75 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $7.41 | Professional | None | $4.90 | $5.89 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.75 Typical High $2.95 | Professional | 52 · Reduced service | $2.45 | $2.75 | $2.95 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $4.57 Typical High $7.76 | Professional | None | $3.80 | $4.57 | $7.76 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $5.75 Median $5.75 Typical High $8.71 | Professional | QW · Waived lab test | $5.75 | $5.75 | $8.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.37 Median $6.46 Typical High $10.96 | Facility | None | $4.37 | $6.46 | $10.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $8.32 | Professional | None | $3.63 | $4.47 | $8.32 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.50 Median $23.44 Typical High $85.11 | Facility | None | $5.50 | $23.44 | $85.11 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $4.27 | Facility | 52 · Reduced service | $2.75 | $2.75 | $4.27 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.57 Median $6.76 Typical High $12.59 | Professional | None | $4.57 | $6.76 | $12.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $5.75 Median $6.92 Typical High $10.47 | Professional | QW · Waived lab test | $5.75 | $6.92 | $10.47 |
Priority Health Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $7.08 | Professional | None | $3.63 | $4.47 | $7.08 |
United Setting Facility Modifier None Typical Low $3.47 Median $5.25 Typical High $6.92 | Facility | None | $3.47 | $5.25 | $6.92 |
United Setting Professional Modifier None Typical Low $2.45 Median $4.68 Typical High $7.59 | Professional | None | $2.45 | $4.68 | $7.59 |
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 Facility Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.70 | Facility | 53 · Discontinued | $1.10 | $1.10 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.12 Typical High $1.17 | Professional | 53 · Discontinued | $0.98 | $1.12 | $1.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Where Michigan sits
The same service costs 12.9 times more in Vermont 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· 27th of 51
$6.03
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.