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 $7.08 Median $7.24 Typical High $11.22 | Facility | None | $7.08 | $7.24 | $11.22 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $5.62 | Facility | 52 · Reduced service | $3.55 | $3.55 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $9.77 | Professional | None | $6.46 | $7.59 | $9.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.24 Median $3.63 Typical High $3.80 | Professional | 52 · Reduced service | $3.24 | $3.63 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.62 | Professional | None | $5.13 | $5.13 | $5.62 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.62 Median $8.32 Typical High $14.13 | Facility | None | $5.62 | $8.32 | $14.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $5.89 Typical High $10.96 | Professional | None | $4.68 | $5.89 | $10.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.08 Median $28.84 Typical High $75.86 | Facility | None | $7.08 | $28.84 | $75.86 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $5.62 | Facility | 52 · Reduced service | $3.55 | $3.55 | $5.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $6.46 Median $8.71 Typical High $13.80 | Professional | None | $6.46 | $8.71 | $13.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.55 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $7.59 Median $9.12 Typical High $13.49 | Professional | QW · Waived lab test | $7.59 | $9.12 | $13.49 |
Priority Health Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $9.12 | Professional | None | $4.68 | $5.75 | $9.12 |
United Setting Facility Modifier None Typical Low $2.45 Median $6.76 Typical High $9.12 | Facility | None | $2.45 | $6.76 | $9.12 |
United Setting Professional Modifier None Typical Low $3.16 Median $6.17 Typical High $9.77 | Professional | None | $3.16 | $6.17 | $9.77 |
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 $1.45 Median $1.45 Typical High $2.24 | Facility | 53 · Discontinued | $1.45 | $1.45 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.45 Typical High $1.51 | Professional | 53 · Discontinued | $1.29 | $1.45 | $1.51 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.45 |
Where Michigan sits
The same service costs 21.4 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· 29th of 51
$7.76
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.