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 $8.13 Median $8.32 Typical High $10.96 | Facility | None | $8.13 | $8.32 | $10.96 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $6.46 | Facility | 52 · Reduced service | $4.07 | $4.07 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $8.71 Typical High $12.02 | Professional | None | $7.41 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $4.17 Typical High $4.37 | Professional | 52 · Reduced service | $3.63 | $4.17 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $11.75 | Professional | None | $6.92 | $6.92 | $11.75 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.46 Median $9.55 Typical High $16.22 | Facility | None | $6.46 | $9.55 | $16.22 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $7.08 Typical High $12.30 | Professional | None | $5.50 | $7.08 | $12.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.32 Median $39.81 Typical High $109.65 | Facility | None | $8.32 | $39.81 | $109.65 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $6.46 | Facility | 52 · Reduced service | $4.07 | $4.07 | $6.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.41 Median $10.23 Typical High $16.22 | Professional | None | $7.41 | $10.23 | $16.22 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Priority Health Setting Professional Modifier None Typical Low $5.50 Median $8.71 Typical High $11.22 | Professional | None | $5.50 | $8.71 | $11.22 |
United Setting Facility Modifier None Typical Low $2.95 Median $7.76 Typical High $36.31 | Facility | None | $2.95 | $7.76 | $36.31 |
United Setting Professional Modifier None Typical Low $3.63 Median $7.08 Typical High $11.22 | Professional | None | $3.63 | $7.08 | $11.22 |
5 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 $1.62 Median $1.62 Typical High $2.57 | Facility | 53 · Discontinued | $1.62 | $1.62 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.66 Typical High $1.74 | Professional | 53 · Discontinued | $1.48 | $1.66 | $1.74 |
Health Alliance Plan Setting Facility Modifier 59 · Distinct service Typical Low $10.23 Median $47.86 Typical High $173.78 | Facility | 59 · Distinct service | $10.23 | $47.86 | $173.78 |
Health Alliance Plan Setting Facility Modifier XU · Unusual separate service Typical Low $8.13 Median $31.62 Typical High $131.83 | Facility | XU · Unusual separate service | $8.13 | $31.62 | $131.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Where Michigan sits
The same service costs 10.2 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· 26th 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.