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 $4.90 Median $4.90 Typical High $6.61 | Facility | None | $4.90 | $4.90 | $6.61 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $3.80 | Facility | 52 · Reduced service | $2.45 | $2.45 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $6.46 | Professional | None | $4.37 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.45 Typical High $2.57 | Professional | 52 · Reduced service | $2.19 | $2.45 | $2.57 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $6.92 Typical High $6.92 | Professional | None | $4.37 | $6.92 | $6.92 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.90 Median $7.41 Typical High $12.59 | Facility | None | $4.90 | $7.41 | $12.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | None | $1.07 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $4.07 Typical High $7.24 | Professional | None | $3.31 | $4.07 | $7.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.90 Median $13.80 Typical High $60.26 | Facility | None | $4.90 | $13.80 | $60.26 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $3.80 | Facility | 52 · Reduced service | $2.45 | $2.45 | $3.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.47 Median $6.03 Typical High $10.00 | Professional | None | $4.47 | $6.03 | $10.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.45 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $5.13 Median $6.17 Typical High $8.71 | Professional | QW · Waived lab test | $5.13 | $6.17 | $8.71 |
Priority Health Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $6.17 | Professional | None | $3.31 | $3.98 | $6.17 |
United Setting Facility Modifier None Typical Low $3.09 Median $4.57 Typical High $10.47 | Facility | None | $3.09 | $4.57 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.98 Typical High $6.61 | Professional | None | $2.14 | $3.98 | $6.61 |
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 $0.98 Median $0.98 Typical High $1.51 | Facility | 53 · Discontinued | $0.98 | $0.98 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.98 Typical High $1.02 | Professional | 53 · Discontinued | $0.87 | $0.98 | $1.02 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.98 | $0.98 | $0.98 |
Where Michigan sits
The same service costs 9.5 times more in Minnesota than in New Jersey. 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· 32nd of 51
$5.25
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.