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 $0.78 Median $0.78 Typical High $2.00 | Facility | None | $0.78 | $0.78 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.78 Typical High $1.12 | Professional | None | $0.76 | $0.78 | $1.12 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
BCBS Setting Facility Modifier None Typical Low $0.79 Median $1.55 Typical High $3.02 | Facility | None | $0.79 | $1.55 | $3.02 |
BCBS Setting Professional Modifier None Typical Low $0.27 Median $0.28 Typical High $0.31 | Professional | None | $0.27 | $0.28 | $0.31 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.95 Typical High $0.95 | Professional | None | $0.76 | $0.95 | $0.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.45 Median $4.37 Typical High $19.95 | Facility | None | $1.45 | $4.37 | $19.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.71 Median $0.83 Typical High $1.38 | Professional | None | $0.71 | $0.83 | $1.38 |
Priority Health Setting Professional Modifier None Typical Low $0.76 Median $0.95 Typical High $0.95 | Professional | None | $0.76 | $0.95 | $0.95 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.78 Typical High $1.00 | Professional | None | $0.69 | $0.78 | $1.00 |
6 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 $0.38 Median $0.39 Typical High $1.12 | Professional | 52 · Reduced service | $0.38 | $0.39 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.44 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.12 Typical High $0.33 | Professional | 55 · Aftercare only | $0.11 | $0.12 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.22 |
BCBS Setting Professional Modifier JW · Drug discarded Typical Low $0.25 Median $0.26 Typical High $0.27 | Professional | JW · Drug discarded | $0.25 | $0.26 | $0.27 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $2.51 Median $19.05 Typical High $22.39 | Facility | JZ · No drug discarded | $2.51 | $19.05 | $22.39 |
Where Michigan sits
The same service costs 44.7 times more in Minnesota 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· 3rd of 51
$2.04
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.