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 $0.63 Median $0.65 Typical High $2.04 | Facility | None | $0.63 | $0.65 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.63 Typical High $0.66 | Professional | None | $0.62 | $0.63 | $0.66 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.65 Median $1.26 Typical High $2.45 | Facility | None | $0.65 | $1.26 | $2.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.10 Median $0.11 Typical High $0.12 | Professional | None | $0.10 | $0.11 | $0.12 |
Cigna Setting Professional Modifier None Typical Low $0.62 Median $1.02 Typical High $1.02 | Professional | None | $0.62 | $1.02 | $1.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.65 Median $1.78 Typical High $6.03 | Facility | None | $0.65 | $1.78 | $6.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.62 Median $0.66 Typical High $0.91 | Professional | None | $0.62 | $0.66 | $0.91 |
Priority Health Setting Professional Modifier None Typical Low $0.62 Median $1.02 Typical High $1.02 | Professional | None | $0.62 | $1.02 | $1.02 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.85 | Professional | None | $0.65 | $0.65 | $0.85 |
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 $0.31 Median $0.32 Typical High $0.46 | Professional | 52 · Reduced service | $0.31 | $0.32 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.13 Typical High $0.41 | Professional | 53 · Discontinued | $0.12 | $0.13 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.31 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.21 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.09 Median $0.10 Typical High $0.11 | Professional | JW · Drug discarded | $0.09 | $0.10 | $0.11 |
Where Michigan sits
The same service costs 4.7 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· 21st of 51
$0.66
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.