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 $3.02 Median $3.09 Typical High $11.48 | Facility | None | $3.02 | $3.09 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $4.37 | Professional | None | $2.95 | $3.02 | $4.37 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.09 Median $6.17 Typical High $12.02 | Facility | None | $3.09 | $6.17 | $12.02 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.98 Median $1.02 Typical High $1.12 | Professional | None | $0.98 | $1.02 | $1.12 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.16 Median $8.13 Typical High $16.22 | Facility | None | $3.16 | $8.13 | $16.22 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $4.37 | Professional | None | $2.95 | $3.24 | $4.37 |
United Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $5.25 | Professional | None | $3.63 | $4.17 | $5.25 |
6 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 $1.48 Median $1.51 Typical High $5.75 | Professional | 52 · Reduced service | $1.48 | $1.51 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.60 Typical High $2.29 | Professional | 53 · Discontinued | $0.59 | $0.60 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $1.74 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $1.15 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $1.15 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | JZ · No drug discarded | $2.95 | $2.95 | $2.95 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.91 Median $0.98 Typical High $1.02 | Professional | JW · Drug discarded | $0.91 | $0.98 | $1.02 |
Where Michigan sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 42nd 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.