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 $0.81 Median $0.81 Typical High $2.40 | Facility | None | $0.81 | $0.81 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.81 Typical High $1.20 | Professional | None | $0.79 | $0.81 | $1.20 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.83 Median $1.66 Typical High $3.24 | Facility | None | $0.83 | $1.66 | $3.24 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.24 Median $0.25 Typical High $0.28 | Professional | None | $0.24 | $0.25 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.83 Median $3.55 Typical High $8.71 | Facility | None | $0.83 | $3.55 | $8.71 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.79 Median $0.85 Typical High $1.23 | Professional | None | $0.79 | $0.85 | $1.23 |
Priority Health Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | None | $0.79 | $0.79 | $0.81 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.12 | Professional | None | $0.85 | $0.85 | $1.12 |
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 $0.40 Median $0.41 Typical High $1.35 | Professional | 52 · Reduced service | $0.40 | $0.41 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.54 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.41 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.27 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.23 Median $0.24 Typical High $0.24 | Professional | JW · Drug discarded | $0.23 | $0.24 | $0.24 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $1.48 Median $5.25 Typical High $8.91 | Facility | JZ · No drug discarded | $1.48 | $5.25 | $8.91 |
Where Michigan sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 4th of 51
$1.32
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.