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 $0.41 Median $0.42 Typical High $1.23 | Facility | None | $0.41 | $0.42 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.42 Typical High $0.55 | Professional | None | $0.40 | $0.42 | $0.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.43 Median $0.83 Typical High $1.62 | Facility | None | $0.43 | $0.83 | $1.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | None | $0.02 | $0.02 | $0.03 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.56 Typical High $0.56 | Professional | None | $0.40 | $0.56 | $0.56 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.68 Median $1.78 Typical High $7.08 | Facility | None | $0.68 | $1.78 | $7.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.40 Median $0.48 Typical High $1.00 | Professional | None | $0.40 | $0.48 | $1.00 |
Priority Health Setting Professional Modifier None Typical Low $0.40 Median $0.56 Typical High $0.56 | Professional | None | $0.40 | $0.56 | $0.56 |
United Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.58 | Professional | None | $0.43 | $0.43 | $0.58 |
7 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 $0.20 Median $0.21 Typical High $0.21 | Professional | 52 · Reduced service | $0.20 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.27 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.21 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.14 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | JW · Drug discarded | $0.02 | $0.02 | $0.03 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $2.34 Median $7.41 Typical High $8.91 | Facility | JZ · No drug discarded | $2.34 | $7.41 | $8.91 |
Health Alliance Plan Setting Professional Modifier JZ · No drug discarded Typical Low $0.45 Median $0.50 Typical High $0.95 | Professional | JZ · No drug discarded | $0.45 | $0.50 | $0.95 |
Where Michigan sits
The same service costs 4.0 times more in Texas 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· 4th of 51
$0.78
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.