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 $4.07 Median $4.17 Typical High $33.11 | Facility | None | $4.07 | $4.17 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.07 Typical High $33.11 | Professional | None | $3.89 | $4.07 | $33.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.31 Median $12.30 Typical High $23.44 | Facility | None | $6.31 | $12.30 | $23.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.81 Median $0.85 Typical High $0.95 | Professional | None | $0.81 | $0.85 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $5.62 | Professional | None | $3.89 | $5.62 | $5.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.17 Median $11.48 Typical High $29.51 | Facility | None | $4.17 | $11.48 | $29.51 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $10.72 | Professional | None | $3.89 | $4.68 | $10.72 |
Priority Health Setting Professional Modifier None Typical Low $3.89 Median $5.62 Typical High $5.62 | Professional | None | $3.89 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | None | $10.47 | $10.47 | $13.80 |
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 $1.95 Median $2.04 Typical High $16.60 | Professional | 52 · Reduced service | $1.95 | $2.04 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.81 Typical High $6.61 | Professional | 53 · Discontinued | $0.78 | $0.81 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.60 Typical High $5.01 | Professional | 55 · Aftercare only | $0.59 | $0.60 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.40 Typical High $3.31 | Professional | 56 · Pre-op care only | $0.39 | $0.40 | $3.31 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.78 Median $0.81 Typical High $0.85 | Professional | JW · Drug discarded | $0.78 | $0.81 | $0.85 |
Where Michigan sits
The same service costs 3.2 times more in Hawaii 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· 29th of 51
$5.62
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.