How much rates vary
Facilitymedian $21 · 10th to 90th $10 to $26Professionalmedian $10 · 10th to 90th $8 to $12
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 $10.23 Median $10.47 Typical High $25.70 | Facility | None | $10.23 | $10.47 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $11.75 | Professional | None | $10.23 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $5.25 Typical High $5.37 | Professional | 52 · Reduced service | $5.13 | $5.25 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.09 Typical High $2.14 | Professional | 53 · Discontinued | $2.04 | $2.09 | $2.14 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $10.72 Typical High $11.48 | Professional | None | $6.92 | $10.72 | $11.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
BCBS Michigan Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $10.23 | Professional | None | $8.51 | $9.55 | $10.23 |
CareSource Setting Professional Modifier None Typical Low $8.32 Median $8.51 Typical High $9.77 | Professional | None | $8.32 | $8.51 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $25.12 | Professional | None | $8.51 | $11.48 | $25.12 |
Health Alliance Plan Setting Facility Modifier None Typical Low $10.47 Median $22.91 Typical High $25.70 | Facility | None | $10.47 | $22.91 | $25.70 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $26.30 | Professional | None | $7.94 | $10.72 | $26.30 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $5.37 | $5.37 | $5.37 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.14 |
Priority Health Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $22.91 | Professional | None | $8.51 | $10.96 | $22.91 |
United Setting Professional Modifier None Typical Low $8.32 Median $9.55 Typical High $10.96 | Professional | None | $8.32 | $9.55 | $10.96 |
10 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 59 · Distinct service | $8.13 | $8.13 | $8.13 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $9.77 Median $9.77 Typical High $15.14 | Professional | 76 · Repeat, same provider | $9.77 | $9.77 | $15.14 |
Ambetter Setting Professional Modifier 77 · Repeat, other provider Typical Low $9.77 Median $10.96 Typical High $10.96 | Professional | 77 · Repeat, other provider | $9.77 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | GC · Resident with teaching physician | $9.77 | $9.77 | $9.77 |
Ambetter Setting Professional Modifier XE · Separate encounter Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | XE · Separate encounter | $8.51 | $8.51 | $8.51 |
Health Alliance Plan Setting Professional Modifier 59 · Distinct service Typical Low $6.03 Median $8.32 Typical High $28.18 | Professional | 59 · Distinct service | $6.03 | $8.32 | $28.18 |
Health Alliance Plan Setting Professional Modifier 76 · Repeat, same provider Typical Low $3.89 Median $8.13 Typical High $22.91 | Professional | 76 · Repeat, same provider | $3.89 | $8.13 | $22.91 |
Health Alliance Plan Setting Professional Modifier 77 · Repeat, other provider Typical Low $6.03 Median $8.32 Typical High $102.33 | Professional | 77 · Repeat, other provider | $6.03 | $8.32 | $102.33 |
Health Alliance Plan Setting Professional Modifier XE · Separate encounter Typical Low $6.61 Median $7.94 Typical High $102.33 | Professional | XE · Separate encounter | $6.61 | $7.94 | $102.33 |
Health Alliance Plan Setting Professional Modifier XU · Unusual separate service Typical Low $7.76 Median $8.32 Typical High $14.45 | Professional | XU · Unusual separate service | $7.76 | $8.32 | $14.45 |
Where Michigan sits
The same service costs 2.5 times more in Alaska 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· 31st of 51
$10.23
AK $20.42MD $8.32
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.