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 $5.62 Median $15.85 Typical High $17.78 | Facility | None | $5.62 | $15.85 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.62 Typical High $15.85 | Professional | None | $5.50 | $5.62 | $15.85 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.75 Median $11.48 Typical High $21.88 | Facility | None | $5.75 | $11.48 | $21.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $6.17 | Professional | None | $5.25 | $5.62 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $6.46 Median $14.79 Typical High $17.78 | Facility | None | $6.46 | $14.79 | $17.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.50 Median $5.62 Typical High $7.41 | Professional | None | $5.50 | $5.62 | $7.41 |
Priority Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $6.17 Typical High $7.94 | Professional | None | $5.50 | $6.17 | $7.94 |
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 $2.75 Median $2.82 Typical High $7.94 | Professional | 52 · Reduced service | $2.75 | $2.82 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.12 Typical High $3.24 | Professional | 53 · Discontinued | $1.10 | $1.12 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $2.40 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.56 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.55 | $0.56 | $1.58 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $5.01 Median $5.25 Typical High $5.50 | Professional | JW · Drug discarded | $5.01 | $5.25 | $5.50 |
Where Michigan sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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· 20th of 51
$5.75
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.