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 $1.10 Median $3.09 Typical High $3.47 | Facility | None | $1.10 | $3.09 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.17 | Professional | None | $1.10 | $1.10 | $1.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.20 Median $2.34 Typical High $4.47 | Facility | None | $1.20 | $2.34 | $4.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.10 Median $1.15 Typical High $1.26 | Professional | None | $1.10 | $1.15 | $1.26 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.23 Median $3.09 Typical High $4.27 | Facility | None | $1.23 | $3.09 | $4.27 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.10 Median $1.45 Typical High $1.95 | Professional | None | $1.10 | $1.45 | $1.95 |
Priority Health Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.55 | Professional | None | $1.15 | $1.15 | $1.55 |
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 $0.55 Median $0.55 Typical High $1.74 | Professional | 52 · Reduced service | $0.55 | $0.55 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.69 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.51 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.34 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.02 Median $1.07 Typical High $1.12 | Professional | JW · Drug discarded | $1.02 | $1.07 | $1.12 |
Where Michigan sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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· 25th of 51
$1.17
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.