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 $13.80 Median $17.78 Typical High $61.66 | Facility | None | $13.80 | $17.78 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $38.90 Typical High $57.54 | Professional | None | $13.49 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $2.69 | $9.12 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $50.12 | Professional | None | $10.00 | $11.75 | $50.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $457.09 | Facility | None | $97.72 | $234.42 | $457.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $100.00 | Professional | None | $15.85 | $19.95 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $63.10 | Professional | None | $38.02 | $51.29 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $45.71 Typical High $85.11 | Professional | None | $12.30 | $45.71 | $85.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $54.95 Median $186.21 Typical High $645.65 | Facility | None | $54.95 | $186.21 | $645.65 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.88 Median $48.98 Typical High $64.57 | Professional | None | $12.88 | $48.98 | $64.57 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.09 Typical High $11.22 | Professional | 53 · Discontinued | $2.95 | $3.09 | $11.22 |
Priority Health Setting Professional Modifier None Typical Low $12.30 Median $46.77 Typical High $85.11 | Professional | None | $12.30 | $46.77 | $85.11 |
United Setting Professional Modifier None Typical Low $12.59 Median $43.65 Typical High $61.66 | Professional | None | $12.59 | $43.65 | $61.66 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | GC · Resident with teaching physician | $15.85 | $15.85 | $15.85 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | Q6 · Substitute physician, paid per time | $47.86 | $47.86 | $47.86 |
Health Alliance Plan Setting Facility Modifier XU · Unusual separate service Typical Low $72.44 Median $83.18 Typical High $190.55 | Facility | XU · Unusual separate service | $72.44 | $83.18 | $190.55 |
Health Alliance Plan Setting Professional Modifier 59 · Distinct service Typical Low $11.48 Median $13.80 Typical High $30.90 | Professional | 59 · Distinct service | $11.48 | $13.80 | $30.90 |
Health Alliance Plan Setting Professional Modifier XU · Unusual separate service Typical Low $11.48 Median $21.38 Typical High $97.72 | Professional | XU · Unusual separate service | $11.48 | $21.38 | $97.72 |
Where Michigan sits
The same service costs 6.8 times more in Minnesota than in Georgia. 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· 44th of 51
$21.38
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.