How much rates vary
Facilitymedian $9 · 10th to 90th $4 to $35Professionalmedian $4 · 10th to 90th $1 to $6
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 $3.72 Median $3.80 Typical High $5.75 | Facility | None | $3.72 | $3.80 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.98 Typical High $5.01 | Professional | None | $3.47 | $3.98 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.37 | Professional | None | $3.89 | $3.89 | $5.37 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $3.31 Median $3.89 Typical High $5.89 | Professional | QW · Waived lab test | $3.31 | $3.89 | $5.89 |
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 $1.29 Median $1.29 Typical High $1.70 | Professional | None | $1.29 | $1.29 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $3.24 Typical High $5.62 | Professional | None | $2.51 | $3.24 | $5.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.72 Median $11.22 Typical High $48.98 | Facility | None | $3.72 | $11.22 | $48.98 |
Health Alliance Plan Setting Facility Modifier QW · Waived lab test Typical Low $4.68 Median $13.80 Typical High $79.43 | Facility | QW · Waived lab test | $4.68 | $13.80 | $79.43 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.47 Median $4.57 Typical High $8.71 | Professional | None | $3.47 | $4.57 | $8.71 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $3.89 Median $4.68 Typical High $7.08 | Professional | QW · Waived lab test | $3.89 | $4.68 | $7.08 |
Priority Health Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $5.01 | Professional | None | $2.51 | $3.16 | $5.01 |
United Setting Facility Modifier None Typical Low $2.34 Median $3.55 Typical High $10.47 | Facility | None | $2.34 | $3.55 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $5.13 Typical High $5.37 | Professional | None | $2.34 | $5.13 | $5.37 |
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 $1.86 Median $1.86 Typical High $2.88 | Facility | 52 · Reduced service | $1.86 | $1.86 | $2.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $1.15 | Facility | 53 · Discontinued | $0.76 | $0.76 | $1.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.91 Typical High $2.00 | Professional | 52 · Reduced service | $1.66 | $1.91 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.76 Typical High $0.79 | Professional | 53 · Discontinued | $0.68 | $0.76 | $0.79 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $1.86 Median $1.86 Typical High $2.88 | Facility | 52 · Reduced service | $1.86 | $1.86 | $2.88 |
Health Alliance Plan Setting Facility Modifier 91 · Repeat lab test Typical Low $3.72 Median $9.12 Typical High $33.11 | Facility | 91 · Repeat lab test | $3.72 | $9.12 | $33.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.86 | $1.86 | $1.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.76 | $0.76 | $0.76 |
Where Michigan sits
The same service costs 12.6 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· 31st of 51
$4.17
VT $39.81DC $3.16
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.