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 $4.07 Median $4.07 Typical High $5.50 | Facility | None | $4.07 | $4.07 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.37 Typical High $5.50 | Professional | None | $3.63 | $4.37 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $5.75 Typical High $5.75 | Professional | None | $4.27 | $5.75 | $5.75 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $1.82 Median $4.27 Typical High $5.62 | Professional | QW · Waived lab test | $1.82 | $4.27 | $5.62 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.24 Median $4.79 Typical High $8.91 | Facility | None | $3.24 | $4.79 | $8.91 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.27 | Professional | None | $3.24 | $3.24 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $6.17 | Professional | None | $2.51 | $3.16 | $6.17 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.17 Median $16.98 Typical High $57.54 | Facility | None | $4.17 | $16.98 | $57.54 |
Health Alliance Plan Setting Facility Modifier QW · Waived lab test Typical Low $4.27 Median $5.25 Typical High $42.66 | Facility | QW · Waived lab test | $4.27 | $5.25 | $42.66 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.63 Median $4.90 Typical High $7.41 | Professional | None | $3.63 | $4.90 | $7.41 |
Health Alliance Plan Setting Professional Modifier QW · Waived lab test Typical Low $4.27 Median $4.90 Typical High $7.76 | Professional | QW · Waived lab test | $4.27 | $4.90 | $7.76 |
Priority Health Setting Professional Modifier None Typical Low $2.51 Median $3.02 Typical High $5.13 | Professional | None | $2.51 | $3.02 | $5.13 |
United Setting Facility Modifier None Typical Low $1.26 Median $3.89 Typical High $10.47 | Facility | None | $1.26 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $2.57 Median $5.37 Typical High $5.62 | Professional | None | $2.57 | $5.37 | $5.62 |
7 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 $2.04 Median $2.04 Typical High $3.16 | Facility | 52 · Reduced service | $2.04 | $2.04 | $3.16 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $1.26 | Facility | 53 · Discontinued | $0.81 | $0.81 | $1.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $2.04 Typical High $2.19 | Professional | 52 · Reduced service | $1.82 | $2.04 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.81 Typical High $0.87 | Professional | 53 · Discontinued | $0.72 | $0.81 | $0.87 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.04 Median $2.04 Typical High $3.16 | Facility | 52 · Reduced service | $2.04 | $2.04 | $3.16 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.81 |
Where Michigan sits
The same service costs 14.8 times more in Minnesota 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· 19th of 51
$5.25
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.