How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1.29 Median $1.29 Typical High $1.32 | Facility | None | $1.29 | $1.29 | $1.32 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.32 Typical High $1.32 | Professional | None | $1.29 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.89 Median $6.31 Typical High $6.31 | Professional | None | $5.89 | $6.31 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.66 | Professional | None | $1.02 | $1.02 | $1.66 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.26 Median $3.47 Typical High $7.24 | Facility | None | $1.26 | $3.47 | $7.24 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.12 Median $1.20 Typical High $1.70 | Professional | None | $1.12 | $1.20 | $1.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Priority Health Setting Professional Modifier None Typical Low $1.02 Median $6.76 Typical High $6.76 | Professional | None | $1.02 | $6.76 | $6.76 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.85 Typical High $10.23 | Professional | None | $0.71 | $0.85 | $10.23 |
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 KS · Glucose supply, no insulin Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | KS · Glucose supply, no insulin | $1.12 | $1.12 | $1.12 |
Cigna Setting Professional Modifier KL · Delivered by mail Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | KL · Delivered by mail | $6.76 | $6.76 | $6.76 |
Health Alliance Plan Setting Professional Modifier KL · Delivered by mail Typical Low $8.71 Median $8.71 Typical High $14.79 | Professional | KL · Delivered by mail | $8.71 | $8.71 | $14.79 |
Priority Health Setting Professional Modifier KL · Delivered by mail Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | KL · Delivered by mail | $6.76 | $6.76 | $6.76 |
Where Michigan sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 30th of 51
$1.32
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.