How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $28Professionalmedian $2 · 10th to 90th $2 to $4
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 $2.24 Median $2.29 Typical High $3.55 | Facility | None | $2.24 | $2.29 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.40 Typical High $3.09 | Professional | None | $2.04 | $2.40 | $3.09 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.34 Typical High $3.24 | Professional | None | $2.00 | $2.34 | $3.24 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $2.00 Median $2.34 Typical High $3.55 | Professional | QW · Waived lab test | $2.00 | $2.34 | $3.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.78 Median $2.63 Typical High $4.90 | Facility | None | $1.78 | $2.63 | $4.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.34 | Professional | None | $1.78 | $1.78 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $3.09 | Professional | None | $1.58 | $1.95 | $3.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.24 Median $7.76 Typical High $32.36 | Facility | None | $2.24 | $7.76 | $32.36 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.24 Median $2.95 Typical High $5.37 | Professional | None | $2.24 | $2.95 | $5.37 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $2.34 Median $2.82 Typical High $5.37 | Professional | QW · Waived lab test | $2.34 | $2.82 | $5.37 |
Priority Health Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $2.88 | Professional | None | $1.58 | $1.95 | $2.88 |
United Setting Facility Modifier None Typical Low $1.41 Median $2.14 Typical High $7.59 | Facility | None | $1.41 | $2.14 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $3.24 Typical High $3.39 | Professional | None | $1.41 | $3.24 | $3.39 |
9 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 $1.12 Median $1.12 Typical High $1.78 | Facility | 52 · Reduced service | $1.12 | $1.12 | $1.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.71 | Facility | 53 · Discontinued | $0.45 | $0.45 | $0.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.12 Typical High $1.20 | Professional | 52 · Reduced service | $1.00 | $1.12 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.46 Typical High $0.48 | Professional | 53 · Discontinued | $0.40 | $0.46 | $0.48 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $1.12 Median $1.12 Typical High $1.78 | Facility | 52 · Reduced service | $1.12 | $1.12 | $1.78 |
Health Alliance Plan Setting Facility Modifier 59 · Distinct service Typical Low $3.98 Median $20.42 Typical High $26.30 | Facility | 59 · Distinct service | $3.98 | $20.42 | $26.30 |
Health Alliance Plan Setting Facility Modifier 91 · Repeat lab test Typical Low $2.24 Median $9.12 Typical High $26.92 | Facility | 91 · Repeat lab test | $2.24 | $9.12 | $26.92 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 53 · Discontinued | $0.45 | $0.45 | $0.45 |
Where Michigan sits
The same service costs 16.6 times more in Minnesota than in Washington, DC. 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· 33rd of 51
$2.45
MN $31.62DC $1.91
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.