How much rates vary
Facilitymedian $9 · 10th to 90th $4 to $19Professionalmedian $4 · 10th to 90th $1 to $4
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 $3.98 Median $3.98 Typical High $4.07 | Facility | None | $3.98 | $3.98 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $3.98 Typical High $4.07 | Professional | None | $1.20 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $2.04 Typical High $2.04 | Professional | 52 · Reduced service | $1.95 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.81 Typical High $0.81 | Professional | 53 · Discontinued | $0.79 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.62 Typical High $0.62 | Professional | 55 · Aftercare only | $0.59 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.41 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.39 | $0.41 | $0.41 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.25 Median $12.30 Typical High $23.44 | Facility | None | $5.25 | $12.30 | $23.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | None | $4.17 | $4.37 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $3.72 Median $5.25 Typical High $5.25 | Professional | None | $3.72 | $5.25 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $5.25 | Professional | None | $2.24 | $2.24 | $5.25 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | AU · Urologic/ostomy supply | $3.16 | $3.16 | $3.16 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.24 Median $3.63 Typical High $6.31 | Facility | None | $3.24 | $3.63 | $6.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.14 Median $3.31 Typical High $3.72 | Professional | None | $2.14 | $3.31 | $3.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.66 | $1.86 | $1.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.68 | $0.76 | $0.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.50 | $0.56 | $0.56 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.33 | $0.38 | $0.38 |
Health Alliance Plan Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $3.16 Typical High $4.27 | Professional | AU · Urologic/ostomy supply | $1.20 | $3.16 | $4.27 |
Priority Health Setting Professional Modifier None Typical Low $2.24 Median $3.16 Typical High $3.16 | Professional | None | $2.24 | $3.16 | $3.16 |
Priority Health Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | AU · Urologic/ostomy supply | $3.16 | $3.16 | $3.16 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.04 Typical High $2.63 | Professional | None | $1.55 | $2.04 | $2.63 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | RR · Rental | $4.37 | $4.37 | $4.37 |
Where Michigan sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 6th of 51
$3.72
MN $5.25NH $1.20
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.