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 $6.17 Median $6.17 Typical High $9.55 | Facility | None | $6.17 | $6.17 | $9.55 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $4.79 | Facility | 52 · Reduced service | $3.09 | $3.09 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $6.46 Typical High $8.51 | Professional | None | $5.50 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $3.09 Typical High $3.24 | Professional | 52 · Reduced service | $2.75 | $3.09 | $3.24 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $6.46 | Professional | None | $4.37 | $5.13 | $6.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.79 Median $7.24 Typical High $12.02 | Facility | None | $4.79 | $7.24 | $12.02 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $5.37 Typical High $9.33 | Professional | None | $4.07 | $5.37 | $9.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $6.17 Median $21.88 Typical High $72.44 | Facility | None | $6.17 | $21.88 | $72.44 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $4.79 | Facility | 52 · Reduced service | $3.09 | $3.09 | $4.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.37 Median $6.92 Typical High $13.18 | Professional | None | $5.37 | $6.92 | $13.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $3.09 | $3.09 | $3.09 |
Priority Health Setting Professional Modifier None Typical Low $4.07 Median $6.46 Typical High $8.32 | Professional | None | $4.07 | $6.46 | $8.32 |
United Setting Facility Modifier None Typical Low $1.95 Median $5.75 Typical High $18.20 | Facility | None | $1.95 | $5.75 | $18.20 |
United Setting Professional Modifier None Typical Low $2.69 Median $5.37 Typical High $8.32 | Professional | None | $2.69 | $5.37 | $8.32 |
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 $1.23 Median $1.23 Typical High $1.91 | Facility | 53 · Discontinued | $1.23 | $1.23 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.23 Typical High $1.32 | Professional | 53 · Discontinued | $1.10 | $1.23 | $1.32 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.23 | $1.23 | $1.23 |
Where Michigan sits
The same service costs 13.2 times more in Vermont than in Maryland. 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
$6.46
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.