How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.12 Median $2.95 Typical High $3.31 | Facility | None | $1.12 | $2.95 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.17 Median $2.29 Typical High $4.37 | Facility | None | $1.17 | $2.29 | $4.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.05 Median $1.12 Typical High $1.12 | Professional | None | $1.05 | $1.12 | $1.12 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.00 Median $1.05 Typical High $1.05 | Professional | JW · Drug discarded | $1.00 | $1.05 | $1.05 |
CareSource Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $2.00 | Professional | None | $1.48 | $1.48 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.86 | Professional | None | $1.10 | $1.10 | $1.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $3.31 | Facility | None | $1.29 | $1.29 | $3.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.07 Median $1.10 Typical High $1.45 | Professional | None | $1.07 | $1.10 | $1.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Priority Health Setting Professional Modifier None Typical Low $1.10 Median $1.86 Typical High $1.86 | Professional | None | $1.10 | $1.86 | $1.86 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.10 | Professional | None | $1.02 | $1.02 | $1.10 |
4 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 |
|---|---|---|---|---|---|
Health Alliance Plan Setting Professional Modifier EC · Anemia drug, other cause Typical Low $5.13 Median $8.51 Typical High $9.77 | Professional | EC · Anemia drug, other cause | $5.13 | $8.51 | $9.77 |
Health Alliance Plan Setting Professional Modifier JA · Given by IV Typical Low $5.01 Median $8.13 Typical High $9.77 | Professional | JA · Given by IV | $5.01 | $8.13 | $9.77 |
Health Alliance Plan Setting Professional Modifier JB · Given under the skin Typical Low $3.89 Median $8.32 Typical High $9.33 | Professional | JB · Given under the skin | $3.89 | $8.32 | $9.33 |
Health Alliance Plan Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $9.33 Typical High $11.48 | Professional | JZ · No drug discarded | $8.13 | $9.33 | $11.48 |
Where Michigan sits
The same service costs 2.7 times more in Wyoming 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· 16th of 51
$1.12
WY $2.95AL $1.10
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.