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 $0.26 Median $0.39 Typical High $1.00 | Facility | None | $0.26 | $0.39 | $1.00 |
Aetna Setting Professional Modifier None Typical Low $0.26 Median $0.32 Typical High $0.41 | Professional | None | $0.26 | $0.32 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.04 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.44 Median $1.12 Typical High $2.19 | Facility | None | $0.44 | $1.12 | $2.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.37 Median $0.44 Typical High $0.44 | Professional | None | $0.37 | $0.44 | $0.44 |
Cigna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.44 Median $0.49 Typical High $2.04 | Facility | None | $0.44 | $0.49 | $2.04 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.40 Median $0.51 Typical High $0.89 | Professional | None | $0.40 | $0.51 | $0.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Priority Health Setting Professional Modifier None Typical Low $0.24 Median $0.31 Typical High $3.47 | Professional | None | $0.24 | $0.31 | $3.47 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.55 Typical High $0.78 | Professional | None | $0.23 | $0.55 | $0.78 |
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 |
|---|---|---|---|---|---|
Priority Health Setting Professional Modifier BO · Nutrition taken by mouth Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | BO · Nutrition taken by mouth | $0.46 | $0.46 | $0.46 |
Where Michigan sits
The same service costs 3.1 times more in Florida than in Alabama. 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· 20th of 51
$0.44
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.