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 $0.52 Median $0.52 Typical High $0.59 | Facility | None | $0.52 | $0.52 | $0.59 |
Aetna Setting Professional Modifier None Typical Low $0.52 Median $0.60 Typical High $0.60 | Professional | None | $0.52 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.62 Median $3.80 Typical High $7.08 | Facility | None | $1.62 | $3.80 | $7.08 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | None | $1.29 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.82 | Professional | None | $0.91 | $0.91 | $1.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.49 Median $1.78 Typical High $1.95 | Facility | None | $0.49 | $1.78 | $1.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.49 Median $0.66 Typical High $0.85 | Professional | None | $0.49 | $0.66 | $0.85 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Priority Health Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.82 | Professional | None | $0.91 | $0.91 | $1.82 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.43 Typical High $0.60 | Professional | None | $0.36 | $0.43 | $0.60 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | RR · Rental | $1.35 | $1.35 | $1.35 |
Where Michigan sits
The same service costs 190.5 times more in Wyoming than in Rhode Island. 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· 35th of 51
$0.60
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.