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 $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.40 Typical High $2.40 | Professional | None | $2.29 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.12 Median $1.20 Typical High $1.20 | Professional | 52 · Reduced service | $1.12 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.48 Typical High $0.48 | Professional | 53 · Discontinued | $0.46 | $0.48 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.34 | $0.36 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.23 | $0.24 | $0.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.02 Median $7.41 Typical High $14.13 | Facility | None | $3.02 | $7.41 | $14.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.40 Median $2.51 Typical High $2.51 | Professional | None | $2.40 | $2.51 | $2.51 |
CareSource Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.70 | Professional | None | $1.26 | $1.26 | $1.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.70 Median $1.95 Typical High $5.37 | Facility | None | $1.70 | $1.95 | $5.37 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.70 Median $2.00 Typical High $2.57 | Professional | None | $1.70 | $2.00 | $2.57 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | 52 · Reduced service | $0.98 | $0.98 | $0.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.39 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Priority Health Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Priority Health Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.82 | Professional | None | $1.26 | $1.26 | $1.82 |
United Setting Professional Modifier None Typical Low $0.89 Median $1.20 Typical High $1.70 | Professional | None | $0.89 | $1.20 | $1.70 |
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 $2.51 Median $2.51 Typical High $2.51 | Professional | RR · Rental | $2.51 | $2.51 | $2.51 |
Where Michigan sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$2.14
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.