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 $3.47 Median $3.47 Typical High $5.89 | Facility | None | $3.47 | $3.47 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.89 Typical High $4.17 | Professional | None | $3.47 | $3.89 | $4.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $10.47 Median $15.85 Typical High $26.92 | Facility | None | $10.47 | $15.85 | $26.92 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | None | $10.00 | $10.47 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $3.72 | Professional | None | $0.60 | $0.60 | $3.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.31 Median $9.12 Typical High $22.39 | Facility | None | $3.31 | $9.12 | $22.39 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.44 Median $3.24 Typical High $4.79 | Professional | None | $0.44 | $3.24 | $4.79 |
Priority Health Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $3.72 | Professional | None | $0.60 | $0.60 | $3.72 |
United Setting Professional Modifier None Typical Low $2.57 Median $3.09 Typical High $9.55 | Professional | None | $2.57 | $3.09 | $9.55 |
8 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 52 · Reduced service Typical Low $1.74 Median $1.95 Typical High $2.09 | Professional | 52 · Reduced service | $1.74 | $1.95 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.78 Typical High $0.83 | Professional | 53 · Discontinued | $0.69 | $0.78 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.59 Typical High $0.63 | Professional | 55 · Aftercare only | $0.52 | $0.59 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.39 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.35 | $0.39 | $0.42 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Where Michigan sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 26th of 51
$3.89
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.