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 $0.85 Median $0.85 Typical High $0.87 | Facility | None | $0.85 | $0.85 | $0.87 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.89 Typical High $0.89 | Professional | None | $0.85 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.45 Typical High $0.45 | Professional | 52 · Reduced service | $0.43 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.17 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.12 Median $2.69 Typical High $5.01 | Facility | None | $1.12 | $2.69 | $5.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.89 Median $0.95 Typical High $0.95 | Professional | None | $0.89 | $0.95 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.56 Typical High $0.56 | Professional | None | $0.49 | $0.56 | $0.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.72 Median $1.82 Typical High $2.00 | Facility | None | $0.72 | $1.82 | $2.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.68 Median $0.72 Typical High $0.89 | Professional | None | $0.68 | $0.72 | $0.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 52 · Reduced service | $0.37 | $0.37 | $0.37 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Priority Health Setting Professional Modifier None Typical Low $0.49 Median $0.56 Typical High $0.56 | Professional | None | $0.49 | $0.56 | $0.56 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.44 Typical High $0.56 | Professional | None | $0.34 | $0.44 | $0.56 |
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 $0.95 Median $0.95 Typical High $0.95 | Professional | RR · Rental | $0.95 | $0.95 | $0.95 |
Where Michigan sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$0.79
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.