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 $5.75 Median $5.75 Typical High $7.76 | Facility | None | $5.75 | $5.75 | $7.76 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.88 Median $2.88 Typical High $4.47 | Facility | 52 · Reduced service | $2.88 | $2.88 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $6.03 Typical High $7.94 | Professional | None | $5.13 | $6.03 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.57 Median $2.88 Typical High $3.02 | Professional | 52 · Reduced service | $2.57 | $2.88 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.47 Median $6.76 Typical High $11.22 | Facility | None | $4.47 | $6.76 | $11.22 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $8.71 | Professional | None | $3.80 | $4.90 | $8.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.75 Median $23.44 Typical High $67.61 | Facility | None | $5.75 | $23.44 | $67.61 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.88 Median $2.88 Typical High $4.47 | Facility | 52 · Reduced service | $2.88 | $2.88 | $4.47 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.13 Median $7.08 Typical High $10.72 | Professional | None | $5.13 | $7.08 | $10.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.88 | $2.88 | $2.88 |
Priority Health Setting Professional Modifier None Typical Low $3.80 Median $6.03 Typical High $7.76 | Professional | None | $3.80 | $6.03 | $7.76 |
United Setting Facility Modifier None Typical Low $2.00 Median $5.37 Typical High $15.14 | Facility | None | $2.00 | $5.37 | $15.14 |
United Setting Professional Modifier None Typical Low $2.51 Median $4.90 Typical High $7.76 | Professional | None | $2.51 | $4.90 | $7.76 |
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 $1.12 Median $1.12 Typical High $1.78 | Facility | 53 · Discontinued | $1.12 | $1.12 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.15 Typical High $1.20 | Professional | 53 · Discontinued | $1.02 | $1.15 | $1.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.12 |
Where Michigan sits
The same service costs 14.5 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· 21st of 51
$7.08
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.