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 $3.63 Median $10.00 Typical High $11.22 | Facility | None | $3.63 | $10.00 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $11.22 | Professional | None | $3.55 | $3.63 | $11.22 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.72 Median $7.41 Typical High $13.80 | Facility | None | $3.72 | $7.41 | $13.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $3.98 | Professional | None | $3.39 | $3.55 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.80 Median $9.55 Typical High $11.22 | Facility | None | $3.80 | $9.55 | $11.22 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $4.79 | Professional | None | $3.55 | $3.63 | $4.79 |
Priority Health Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.68 | Professional | None | $3.55 | $3.55 | $4.68 |
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 $1.78 Median $1.82 Typical High $5.62 | Professional | 52 · Reduced service | $1.78 | $1.82 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $2.24 | Professional | 53 · Discontinued | $0.71 | $0.72 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.54 Typical High $1.70 | Professional | 55 · Aftercare only | $0.52 | $0.54 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.36 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.35 | $0.36 | $1.12 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $3.24 Median $3.39 Typical High $3.55 | Professional | JW · Drug discarded | $3.24 | $3.39 | $3.55 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 26th of 51
$3.55
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.