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 $0.04 Median $0.04 Typical High $0.04 | Facility | None | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier None Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | None | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 52 · Reduced service | $0.02 | $0.02 | $0.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.78 Median $1.86 Typical High $1.86 | Professional | None | $1.78 | $1.86 | $1.86 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | None | $0.03 | $0.03 | $0.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 52 · Reduced service | $0.02 | $0.02 | $0.02 |
Priority Health Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
3 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $3.02 Typical High $3.80 | Professional | 53 · Discontinued | $0.79 | $3.02 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $2.24 Typical High $2.82 | Professional | 55 · Aftercare only | $0.60 | $2.24 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $1.51 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.40 | $1.51 | $1.91 |
Where Michigan sits
The same service costs 2630.3 times more in Montana than in Nevada. 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· 27th of 51
$0.31
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.