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 $8.51 Median $8.71 Typical High $11.48 | Facility | None | $8.51 | $8.71 | $11.48 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $6.61 | Facility | 52 · Reduced service | $4.27 | $4.27 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $9.12 Typical High $11.75 | Professional | None | $7.76 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.80 Median $4.37 Typical High $4.57 | Professional | 52 · Reduced service | $3.80 | $4.37 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $7.24 Typical High $7.24 | Professional | None | $4.47 | $7.24 | $7.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.76 Median $10.00 Typical High $16.98 | Facility | None | $6.76 | $10.00 | $16.98 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $7.24 Typical High $12.88 | Professional | None | $5.62 | $7.24 | $12.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.71 Median $35.48 Typical High $100.00 | Facility | None | $8.71 | $35.48 | $100.00 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $6.61 | Facility | 52 · Reduced service | $4.27 | $4.27 | $6.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.41 Median $9.55 Typical High $18.62 | Professional | None | $7.41 | $9.55 | $18.62 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
Priority Health Setting Professional Modifier None Typical Low $5.62 Median $9.12 Typical High $11.75 | Professional | None | $5.62 | $9.12 | $11.75 |
United Setting Facility Modifier None Typical Low $5.37 Median $8.13 Typical High $10.72 | Facility | None | $5.37 | $8.13 | $10.72 |
United Setting Professional Modifier None Typical Low $3.80 Median $7.41 Typical High $11.75 | Professional | None | $3.80 | $7.41 | $11.75 |
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 $1.70 Median $1.70 Typical High $2.69 | Facility | 53 · Discontinued | $1.70 | $1.70 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.74 Typical High $1.82 | Professional | 53 · Discontinued | $1.51 | $1.74 | $1.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.70 |
Where Michigan sits
The same service costs 10.7 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· 25th of 51
$10.00
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.