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 $5.25 Median $14.79 Typical High $16.60 | Facility | None | $5.25 | $14.79 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $5.25 | Professional | None | $5.13 | $5.25 | $5.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.25 Median $6.46 Typical High $18.20 | Facility | None | $5.25 | $6.46 | $18.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.79 Median $5.13 Typical High $5.62 | Professional | None | $4.79 | $5.13 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.13 | Professional | None | $4.68 | $4.68 | $5.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.50 Median $13.80 Typical High $16.60 | Facility | None | $5.50 | $13.80 | $16.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $6.92 | Professional | None | $5.13 | $5.25 | $6.92 |
Priority Health Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.13 | Professional | None | $4.68 | $4.68 | $5.13 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $6.92 | Professional | None | $5.13 | $5.13 | $6.92 |
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 $2.57 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.57 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.02 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.78 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.51 | $0.52 | $0.52 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $4.57 Median $4.79 Typical High $5.01 | Professional | JW · Drug discarded | $4.57 | $4.79 | $5.01 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 29th of 51
$5.25
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.