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 $0.71 Median $0.71 Typical High $0.72 | Facility | None | $0.71 | $0.71 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | None | $0.71 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.35 Median $0.37 Typical High $0.37 | Professional | 52 · Reduced service | $0.35 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.14 | $0.15 | $0.15 |
Aetna 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 |
Aetna 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 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.93 Median $2.24 Typical High $4.17 | Facility | None | $0.93 | $2.24 | $4.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.74 Median $0.78 Typical High $0.78 | Professional | None | $0.74 | $0.78 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.50 Typical High $0.50 | Professional | None | $0.40 | $0.50 | $0.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.59 Median $1.51 Typical High $1.62 | Facility | None | $0.59 | $1.51 | $1.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.56 Median $0.59 Typical High $0.74 | Professional | None | $0.56 | $0.59 | $0.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.30 | $0.30 | $0.30 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Priority Health Setting Professional Modifier None Typical Low $0.40 Median $0.50 Typical High $0.50 | Professional | None | $0.40 | $0.50 | $0.50 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.37 Typical High $0.47 | Professional | None | $0.28 | $0.37 | $0.47 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | RR · Rental | $0.78 | $0.78 | $0.78 |
Where Michigan sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 14th of 51
$0.65
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.