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 $12.30 Median $14.79 Typical High $18.62 | Facility | None | $12.30 | $14.79 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $15.14 | Professional | None | $12.30 | $13.49 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $10.72 Median $14.79 Typical High $20.42 | Professional | None | $10.72 | $14.79 | $20.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $11.75 Median $24.55 Typical High $43.65 | Facility | None | $11.75 | $24.55 | $43.65 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.75 Median $12.59 Typical High $18.20 | Professional | None | $11.75 | $12.59 | $18.20 |
CareSource Setting Professional Modifier None Typical Low $13.18 Median $17.78 Typical High $20.89 | Professional | None | $13.18 | $17.78 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $13.49 Typical High $27.54 | Professional | None | $10.47 | $13.49 | $27.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $12.59 Median $26.92 Typical High $67.61 | Facility | None | $12.59 | $26.92 | $67.61 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $17.78 | Professional | None | $12.59 | $15.49 | $17.78 |
Priority Health Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $21.38 | Professional | None | $10.00 | $12.88 | $21.38 |
United Setting Facility Modifier None Typical Low $38.90 Median $50.12 Typical High $104.71 | Facility | None | $38.90 | $50.12 | $104.71 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.80 Typical High $16.60 | Professional | None | $12.30 | $13.80 | $16.60 |
4 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 25 · Same-day visit Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 25 · Same-day visit | $14.79 | $15.49 | $15.49 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | GC · Resident with teaching physician | $14.79 | $14.79 | $14.79 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $15.49 Median $19.95 Typical High $26.92 | Professional | 25 · Same-day visit | $15.49 | $19.95 | $26.92 |
Health Alliance Plan Setting Professional Modifier 59 · Distinct service Typical Low $13.18 Median $33.88 Typical High $33.88 | Professional | 59 · Distinct service | $13.18 | $33.88 | $33.88 |
Where Michigan sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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
$13.80
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.