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 $1.00 Median $1.00 Typical High $1.02 | Facility | None | $1.00 | $1.00 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.02 Typical High $1.02 | Professional | None | $1.00 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.50 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.50 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.32 Median $3.16 Typical High $5.89 | Facility | None | $1.32 | $3.16 | $5.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.05 Median $1.10 Typical High $1.10 | Professional | None | $1.05 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.55 | Professional | None | $0.54 | $0.54 | $0.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.83 Median $2.09 Typical High $2.29 | Facility | None | $0.83 | $2.09 | $2.29 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.78 Median $0.83 Typical High $1.02 | Professional | None | $0.78 | $0.83 | $1.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 52 · Reduced service | $0.42 | $0.42 | $0.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Health Alliance Plan 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 |
Health Alliance Plan 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 |
Priority Health Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.55 | Professional | None | $0.54 | $0.54 | $0.55 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.51 Typical High $0.65 | Professional | None | $0.39 | $0.51 | $0.65 |
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 $1.10 Median $1.10 Typical High $1.10 | Professional | RR · Rental | $1.10 | $1.10 | $1.10 |
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· 13th of 51
$0.91
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.