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 $2.34 Median $2.34 Typical High $2.45 | Facility | None | $2.34 | $2.34 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.45 Typical High $2.45 | Professional | None | $2.34 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.23 Typical High $1.23 | Professional | 52 · Reduced service | $1.17 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 53 · Discontinued | $0.47 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.36 Typical High $0.36 | Professional | 55 · Aftercare only | $0.35 | $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 $3.09 Median $7.59 Typical High $14.45 | Facility | None | $3.09 | $7.59 | $14.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.45 Median $2.57 Typical High $2.57 | Professional | None | $2.45 | $2.57 | $2.57 |
CareSource 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 Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $1.66 | Professional | None | $1.32 | $1.45 | $1.66 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.51 Median $2.00 Typical High $5.50 | Facility | None | $1.51 | $2.00 | $5.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.66 Median $2.00 Typical High $2.63 | Professional | None | $1.66 | $2.00 | $2.63 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.30 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Priority Health Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Priority Health Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $2.00 | Professional | None | $1.45 | $1.45 | $2.00 |
United Setting Professional Modifier None Typical Low $0.91 Median $1.23 Typical High $1.82 | Professional | None | $0.91 | $1.23 | $1.82 |
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 $2.57 Median $2.57 Typical High $2.57 | Professional | RR · Rental | $2.57 | $2.57 | $2.57 |
Where Michigan sits
The same service costs 2.3 times more in Kansas 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· 15th of 51
$2.19
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.