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 $7.41 Median $7.41 Typical High $11.48 | Facility | None | $7.41 | $7.41 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $7.76 Typical High $10.23 | Professional | None | $6.61 | $7.76 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $10.47 | Professional | None | $6.17 | $7.76 | $10.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.89 Median $8.71 Typical High $14.45 | Facility | None | $5.89 | $8.71 | $14.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.76 | Professional | None | $5.89 | $5.89 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $6.03 Typical High $11.48 | Professional | None | $4.90 | $6.03 | $11.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.76 Median $30.90 Typical High $85.11 | Facility | None | $7.76 | $30.90 | $85.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $6.92 Median $9.33 Typical High $16.60 | Professional | None | $6.92 | $9.33 | $16.60 |
Priority Health Setting Professional Modifier None Typical Low $4.90 Median $6.03 Typical High $9.55 | Professional | None | $4.90 | $6.03 | $9.55 |
United Setting Facility Modifier None Typical Low $2.63 Median $6.92 Typical High $9.33 | Facility | None | $2.63 | $6.92 | $9.33 |
United Setting Professional Modifier None Typical Low $3.24 Median $6.46 Typical High $10.00 | Professional | None | $3.24 | $6.46 | $10.00 |
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 $3.72 Median $3.72 Typical High $5.75 | Facility | 52 · Reduced service | $3.72 | $3.72 | $5.75 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.48 Median $1.48 Typical High $2.29 | Facility | 53 · Discontinued | $1.48 | $1.48 | $2.29 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.31 Median $3.72 Typical High $3.89 | Professional | 52 · Reduced service | $3.31 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.48 Typical High $1.58 | Professional | 53 · Discontinued | $1.32 | $1.48 | $1.58 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $6.61 Median $7.76 Typical High $11.75 | Professional | QW · Waived lab test | $6.61 | $7.76 | $11.75 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $3.72 Median $3.72 Typical High $5.75 | Facility | 52 · Reduced service | $3.72 | $3.72 | $5.75 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $3.72 | $3.72 | $3.72 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.48 | $1.48 | $1.48 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $7.76 Median $8.32 Typical High $11.75 | Professional | QW · Waived lab test | $7.76 | $8.32 | $11.75 |
Where Michigan sits
The same service costs 13.5 times more in Minnesota than in North Carolina. 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· 18th of 51
$9.55
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.