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 $4.90 Median $5.01 Typical High $6.61 | Facility | None | $4.90 | $5.01 | $6.61 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $3.80 | Facility | 52 · Reduced service | $2.45 | $2.45 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $7.76 | Professional | None | $4.37 | $5.13 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.51 Typical High $2.63 | Professional | 52 · Reduced service | $2.19 | $2.51 | $2.63 |
Ambetter Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.89 Median $5.75 Typical High $10.72 | Facility | None | $3.89 | $5.75 | $10.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $7.24 | Professional | None | $3.31 | $4.27 | $7.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.25 Median $37.15 Typical High $72.44 | Facility | None | $5.25 | $37.15 | $72.44 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $3.80 | Facility | 52 · Reduced service | $2.45 | $2.45 | $3.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.47 Median $6.17 Typical High $10.47 | Professional | None | $4.47 | $6.17 | $10.47 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.45 |
Priority Health Setting Professional Modifier None Typical Low $3.31 Median $5.13 Typical High $6.76 | Professional | None | $3.31 | $5.13 | $6.76 |
United Setting Facility Modifier None Typical Low $1.70 Median $4.68 Typical High $6.17 | Facility | None | $1.70 | $4.68 | $6.17 |
United Setting Professional Modifier None Typical Low $2.19 Median $4.27 Typical High $6.76 | Professional | None | $2.19 | $4.27 | $6.76 |
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 $0.98 Median $0.98 Typical High $1.55 | Facility | 53 · Discontinued | $0.98 | $0.98 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.00 Typical High $1.05 | Professional | 53 · Discontinued | $0.87 | $1.00 | $1.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.98 | $0.98 | $0.98 |
Where Michigan sits
The same service costs 17.8 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· 18th of 51
$6.17
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.