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 $54.95 Median $56.23 Typical High $58.88 | Facility | None | $54.95 | $56.23 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $57.54 | Professional | None | $54.95 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $28.18 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $83.18 Median $117.49 Typical High $154.88 | Facility | None | $83.18 | $117.49 | $154.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | None | $74.13 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $44.67 Typical High $117.49 | Professional | None | $35.48 | $44.67 | $117.49 |
Health Alliance Plan Setting Facility Modifier None Typical Low $56.23 Median $60.26 Typical High $138.04 | Facility | None | $56.23 | $60.26 | $138.04 |
Health Alliance Plan Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $60.26 | Professional | None | $46.77 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Priority Health Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $74.13 | Professional | None | $33.11 | $43.65 | $74.13 |
United Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $54.95 | Facility | None | $39.81 | $50.12 | $54.95 |
United Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $52.48 | Professional | None | $41.69 | $45.71 | $52.48 |
2 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 |
|---|---|---|---|---|---|
Health Alliance Plan Setting Facility Modifier GO · Occupational therapy plan Typical Low $60.26 Median $83.18 Typical High $120.23 | Facility | GO · Occupational therapy plan | $60.26 | $83.18 | $120.23 |
Health Alliance Plan Setting Professional Modifier GO · Occupational therapy plan Typical Low $74.13 Median $128.82 Typical High $128.82 | Professional | GO · Occupational therapy plan | $74.13 | $128.82 | $128.82 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Utah. 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· 17th of 51
$57.54
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.