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 $2.75 Median $7.41 Typical High $8.32 | Facility | None | $2.75 | $7.41 | $8.32 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $8.32 | Professional | None | $2.69 | $2.75 | $8.32 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.88 Median $5.62 Typical High $10.72 | Facility | None | $2.88 | $5.62 | $10.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.57 Median $2.75 Typical High $3.02 | Professional | None | $2.57 | $2.75 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.02 Median $7.24 Typical High $8.32 | Facility | None | $3.02 | $7.24 | $8.32 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.63 | Professional | None | $2.69 | $2.69 | $3.63 |
Priority Health Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.47 | Professional | None | $2.57 | $2.57 | $3.47 |
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 $1.35 Median $1.38 Typical High $4.17 | Professional | 52 · Reduced service | $1.35 | $1.38 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.55 Typical High $1.66 | Professional | 53 · Discontinued | $0.54 | $0.55 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.42 Typical High $1.26 | Professional | 55 · Aftercare only | $0.40 | $0.42 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.28 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.27 | $0.28 | $0.83 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.45 Median $2.57 Typical High $2.69 | Professional | JW · Drug discarded | $2.45 | $2.57 | $2.69 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 17th of 51
$2.75
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.