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 $0.40 Median $0.42 Typical High $1.51 | Facility | None | $0.40 | $0.42 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.41 Typical High $0.58 | Professional | None | $0.39 | $0.41 | $0.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.42 Median $0.81 Typical High $1.58 | Facility | None | $0.42 | $0.81 | $1.58 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.17 Median $0.18 Typical High $0.20 | Professional | None | $0.17 | $0.18 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.39 Median $0.72 Typical High $0.72 | Professional | None | $0.39 | $0.72 | $0.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.42 Median $1.41 Typical High $2.69 | Facility | None | $0.42 | $1.41 | $2.69 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.39 Median $0.44 Typical High $0.59 | Professional | None | $0.39 | $0.44 | $0.59 |
Priority Health Setting Professional Modifier None Typical Low $0.39 Median $0.72 Typical High $0.72 | Professional | None | $0.39 | $0.72 | $0.72 |
United Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.65 | Professional | None | $0.48 | $0.48 | $0.65 |
5 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 $0.20 Median $0.21 Typical High $0.76 | Professional | 52 · Reduced service | $0.20 | $0.21 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.31 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.23 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.15 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.16 Median $0.17 Typical High $0.18 | Professional | JW · Drug discarded | $0.16 | $0.17 | $0.18 |
Where Michigan sits
The same service costs 5.2 times more in Wyoming than in Georgia. 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
$0.48
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.