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 $0.52 Median $0.79 Typical High $2.00 | Facility | None | $0.52 | $0.79 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.52 Median $0.79 Typical High $0.87 | Professional | None | $0.52 | $0.79 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.12 Typical High $0.13 | Professional | 55 · Aftercare only | $0.08 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.05 | $0.08 | $0.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.93 Median $2.29 Typical High $4.47 | Facility | None | $0.93 | $2.29 | $4.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.79 Median $0.93 Typical High $0.93 | Professional | None | $0.79 | $0.93 | $0.93 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.85 Median $0.95 Typical High $3.16 | Facility | None | $0.85 | $0.95 | $3.16 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.81 Median $1.07 Typical High $1.41 | Professional | None | $0.81 | $1.07 | $1.41 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Priority Health Setting Professional Modifier None Typical Low $0.65 Median $0.71 Typical High $16.22 | Professional | None | $0.65 | $0.71 | $16.22 |
United Setting Professional Modifier None Typical Low $0.48 Median $1.20 Typical High $1.70 | Professional | None | $0.48 | $1.20 | $1.70 |
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 $0.85 Median $0.85 Typical High $0.85 | Professional | BO · Nutrition taken by mouth | $0.85 | $0.85 | $0.85 |
Where Michigan sits
The same service costs 3.2 times more in Texas 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· 25th of 51
$0.93
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.