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 $15.85 Median $16.22 Typical High $25.12 | Facility | None | $15.85 | $16.22 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $16.98 Typical High $21.88 | Professional | None | $14.13 | $16.98 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $8.32 Median $13.49 Typical High $13.49 | Professional | None | $8.32 | $13.49 | $13.49 |
BCBS Michigan Setting Facility Modifier None Typical Low $12.59 Median $17.78 Typical High $31.62 | Facility | None | $12.59 | $17.78 | $31.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $13.18 Typical High $23.99 | Professional | None | $10.72 | $13.18 | $23.99 |
Health Alliance Plan Setting Facility Modifier None Typical Low $16.22 Median $54.95 Typical High $165.96 | Facility | None | $16.22 | $54.95 | $165.96 |
Health Alliance Plan Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $35.48 | Professional | None | $14.13 | $19.05 | $35.48 |
Priority Health Setting Professional Modifier None Typical Low $10.72 Median $12.88 Typical High $20.42 | Professional | None | $10.72 | $12.88 | $20.42 |
United Setting Facility Modifier None Typical Low $5.89 Median $15.14 Typical High $60.26 | Facility | None | $5.89 | $15.14 | $60.26 |
United Setting Professional Modifier None Typical Low $7.08 Median $13.80 Typical High $21.88 | Professional | None | $7.08 | $13.80 | $21.88 |
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 $7.94 Median $7.94 Typical High $12.59 | Facility | 52 · Reduced service | $7.94 | $7.94 | $12.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $5.01 | Facility | 53 · Discontinued | $3.16 | $3.16 | $5.01 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $8.13 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $3.24 Typical High $3.39 | Professional | 53 · Discontinued | $2.88 | $3.24 | $3.39 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $7.94 Median $7.94 Typical High $12.59 | Facility | 52 · Reduced service | $7.94 | $7.94 | $12.59 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $7.94 | $7.94 | $7.94 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $3.16 | $3.16 | $3.16 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $16.98 Median $19.95 Typical High $30.20 | Professional | QW · Waived lab test | $16.98 | $19.95 | $30.20 |
Where Michigan sits
The same service costs 7.8 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· 21st of 51
$19.50
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.