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 $0.79 Median $0.79 Typical High $0.81 | Facility | None | $0.79 | $0.79 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $0.83 | Professional | None | $0.79 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.42 Typical High $0.42 | Professional | 52 · Reduced service | $0.40 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.16 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.05 Median $2.51 Typical High $4.68 | Facility | None | $1.05 | $2.51 | $4.68 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.83 Median $0.87 Typical High $0.87 | Professional | None | $0.83 | $0.87 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.45 | Professional | None | $0.42 | $0.42 | $0.45 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.68 Median $1.66 Typical High $1.82 | Facility | None | $0.68 | $1.66 | $1.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.62 Median $0.68 Typical High $0.81 | Professional | None | $0.62 | $0.68 | $0.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.34 | $0.34 | $0.34 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
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 $0.42 Median $0.42 Typical High $0.45 | Professional | None | $0.42 | $0.42 | $0.45 |
United Setting Professional Modifier None Typical Low $0.31 Median $0.41 Typical High $0.51 | Professional | None | $0.31 | $0.41 | $0.51 |
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 $0.87 Median $0.87 Typical High $0.87 | Professional | RR · Rental | $0.87 | $0.87 | $0.87 |
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· 12th of 51
$0.72
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.