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 $4.47 Median $4.57 Typical High $6.03 | Facility | None | $4.47 | $4.57 | $6.03 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.24 Median $2.24 Typical High $3.55 | Facility | 52 · Reduced service | $2.24 | $2.24 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.79 Typical High $6.17 | Professional | None | $4.07 | $4.79 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.29 Typical High $2.40 | Professional | 52 · Reduced service | $2.04 | $2.29 | $2.40 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
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 $2.95 Median $3.89 Typical High $7.24 | Professional | None | $2.95 | $3.89 | $7.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.57 Median $14.45 Typical High $53.70 | Facility | None | $4.57 | $14.45 | $53.70 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.24 Median $2.24 Typical High $3.55 | Facility | 52 · Reduced service | $2.24 | $2.24 | $3.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.72 Median $5.25 Typical High $7.41 | Professional | None | $3.72 | $5.25 | $7.41 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.24 |
Priority Health Setting Professional Modifier None Typical Low $2.95 Median $4.79 Typical High $6.17 | Professional | None | $2.95 | $4.79 | $6.17 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.27 Typical High $10.47 | Facility | None | $1.38 | $4.27 | $10.47 |
United Setting Professional Modifier None Typical Low $2.00 Median $3.39 Typical High $6.17 | Professional | None | $2.00 | $3.39 | $6.17 |
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 $0.89 Median $0.89 Typical High $1.41 | Facility | 53 · Discontinued | $0.89 | $0.89 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.91 Typical High $0.95 | Professional | 53 · Discontinued | $0.81 | $0.91 | $0.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.89 | $0.89 | $0.89 |
Where Michigan sits
The same service costs 11.7 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· 28th 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.