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 $23.44 Median $30.90 Typical High $32.36 | Facility | None | $23.44 | $30.90 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $32.36 | Professional | None | $22.91 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | 52 · Reduced service | $15.49 | $15.49 | $16.22 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $36.31 | Professional | None | $22.91 | $26.92 | $36.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | None | $38.90 | $40.74 | $40.74 |
CareSource Setting Professional Modifier None Typical Low $28.84 Median $38.90 Typical High $45.71 | Professional | None | $28.84 | $38.90 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $52.48 | Professional | None | $27.54 | $50.12 | $52.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $24.55 Median $31.62 Typical High $34.67 | Facility | None | $24.55 | $31.62 | $34.67 |
Health Alliance Plan Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $33.11 | Professional | None | $23.99 | $28.18 | $33.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Priority Health Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | None | $27.54 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $31.62 Median $36.31 Typical High $39.81 | Professional | None | $31.62 | $36.31 | $39.81 |
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 $27.54 Median $32.36 Typical High $32.36 | Professional | 25 · Same-day visit | $27.54 | $32.36 | $32.36 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | AM · Physician, team member | $32.36 | $32.36 | $32.36 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | GC · Resident with teaching physician | $26.30 | $26.30 | $26.30 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $26.30 Median $30.20 Typical High $69.18 | Professional | 25 · Same-day visit | $26.30 | $30.20 | $69.18 |
Where Michigan sits
The same service costs 2.5 times more in Alaska than in New York. 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· 32nd of 51
$30.90
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.