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 $1.62 Median $1.62 Typical High $1.70 | Facility | None | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.70 Typical High $1.70 | Professional | None | $1.62 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.81 Median $0.85 Typical High $0.85 | Professional | 52 · Reduced service | $0.81 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.34 Typical High $0.34 | Professional | 53 · Discontinued | $0.32 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.19 Median $5.37 Typical High $10.00 | Facility | None | $2.19 | $5.37 | $10.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.70 Median $1.82 Typical High $1.82 | Professional | None | $1.70 | $1.82 | $1.82 |
CareSource Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $1.29 Typical High $1.29 | Professional | None | $0.93 | $1.29 | $1.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.38 Median $3.55 Typical High $3.89 | Facility | None | $1.38 | $3.55 | $3.89 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $1.86 | Professional | None | $1.32 | $1.45 | $1.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 52 · Reduced service | $0.69 | $0.69 | $0.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Priority Health Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Priority Health Setting Professional Modifier None Typical Low $1.10 Median $1.29 Typical High $1.35 | Professional | None | $1.10 | $1.29 | $1.35 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.85 Typical High $1.29 | Professional | None | $0.65 | $0.85 | $1.29 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | RR · Rental | $1.82 | $1.82 | $1.82 |
Where Michigan sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 13th of 51
$1.62
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.