How much rates vary
Facilitymedian $214 · 10th to 90th $33 to $603Professionalmedian $32 · 10th to 90th $24 to $51
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 $27.54 Median $28.18 Typical High $29.51 | Facility | None | $27.54 | $28.18 | $29.51 |
Aetna Setting Facility Modifier TC · Technical part Typical Low $23.44 Median $24.55 Typical High $60.26 | Facility | TC · Technical part | $23.44 | $24.55 | $60.26 |
Aetna Setting Professional Modifier None (both parts) Typical Low $27.54 Median $28.18 Typical High $45.71 | Professional | None (both parts) | $27.54 | $28.18 | $45.71 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $3.63 Median $3.80 Typical High $5.01 | Professional | 26 · Professional part | $3.63 | $3.80 | $5.01 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $24.55 Typical High $37.15 | Professional | TC · Technical part | $23.44 | $24.55 | $37.15 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None (both parts) | $22.91 | $22.91 | $22.91 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $3.24 Median $4.27 Typical High $4.90 | Professional | 26 · Professional part | $3.24 | $4.27 | $4.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $39.81 Median $95.50 Typical High $186.21 | Facility | None | $39.81 | $95.50 | $186.21 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $5.13 Median $36.31 Typical High $38.90 | Professional | None (both parts) | $5.13 | $36.31 | $38.90 |
BCBS Michigan Setting Professional Modifier 26 · Professional part Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 26 · Professional part | $5.50 | $5.50 | $5.50 |
BCBS Michigan Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | TC · Technical part | $33.88 | $33.88 | $33.88 |
CareSource Setting Professional Modifier None (both parts) Typical Low $2.88 Median $19.50 Typical High $27.54 | Professional | None (both parts) | $2.88 | $19.50 | $27.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $22.39 Median $33.11 Typical High $107.15 | Professional | None (both parts) | $22.39 | $33.11 | $107.15 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $3.02 Median $4.47 Typical High $7.94 | Professional | 26 · Professional part | $3.02 | $4.47 | $7.94 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $29.51 Typical High $102.33 | Professional | TC · Technical part | $20.89 | $29.51 | $102.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $53.70 Median $302.00 Typical High $616.60 | Facility | None | $53.70 | $302.00 | $616.60 |
Health Alliance Plan Setting Facility Modifier TC · Technical part Typical Low $24.55 Median $25.70 Typical High $70.79 | Facility | TC · Technical part | $24.55 | $25.70 | $70.79 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $27.54 Median $29.51 Typical High $47.86 | Professional | None (both parts) | $27.54 | $29.51 | $47.86 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $3.63 Median $4.07 Typical High $6.46 | Professional | 26 · Professional part | $3.63 | $4.07 | $6.46 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $23.99 Median $25.70 Typical High $35.48 | Professional | TC · Technical part | $23.99 | $25.70 | $35.48 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $21.88 Median $30.20 Typical High $95.50 | Professional | None (both parts) | $21.88 | $30.20 | $95.50 |
Priority Health Setting Professional Modifier 26 · Professional part Typical Low $3.09 Median $4.17 Typical High $6.46 | Professional | 26 · Professional part | $3.09 | $4.17 | $6.46 |
Priority Health Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $26.92 Typical High $120.23 | Professional | TC · Technical part | $20.89 | $26.92 | $120.23 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $31.62 Typical High $91.20 | Professional | None (both parts) | $25.12 | $31.62 | $91.20 |
United Setting Professional Modifier 26 · Professional part Typical Low $3.24 Median $4.27 Typical High $5.37 | Professional | 26 · Professional part | $3.24 | $4.27 | $5.37 |
United Setting Professional Modifier TC · Technical part Typical Low $21.88 Median $26.30 Typical High $70.79 | Professional | TC · Technical part | $21.88 | $26.30 | $70.79 |
6 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 Professional Modifier 52 · Reduced service Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $13.80 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.50 | $5.62 | $5.62 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | XU · Unusual separate service | $21.88 | $21.88 | $21.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Health Alliance Plan Setting Professional Modifier 59 · Distinct service Typical Low $12.02 Median $38.02 Typical High $100.00 | Professional | 59 · Distinct service | $12.02 | $38.02 | $100.00 |
Where Michigan sits
The same service costs 2.9 times more in Kansas 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· 37th of 51
$32.36
KS $74.13MD $25.70
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.