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 $1.95 Median $2.04 Typical High $6.17 | Facility | None | $1.95 | $2.04 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.88 | Professional | None | $1.91 | $2.00 | $2.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.04 Median $3.98 Typical High $7.59 | Facility | None | $2.04 | $3.98 | $7.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.48 Median $0.51 Typical High $0.56 | Professional | None | $0.48 | $0.51 | $0.56 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.00 | Professional | None | $1.91 | $2.00 | $2.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.82 Median $6.61 Typical High $10.47 | Facility | None | $2.82 | $6.61 | $10.47 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.95 Median $2.09 Typical High $2.95 | Professional | None | $1.95 | $2.09 | $2.95 |
Priority Health Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.00 | Professional | None | $1.91 | $2.00 | $2.00 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.57 | Professional | None | $1.95 | $1.95 | $2.57 |
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 $0.98 Median $1.00 Typical High $3.09 | Professional | 52 · Reduced service | $0.98 | $1.00 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.40 Typical High $1.23 | Professional | 53 · Discontinued | $0.39 | $0.40 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.30 Typical High $0.93 | Professional | 55 · Aftercare only | $0.28 | $0.30 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.20 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.19 | $0.20 | $0.62 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.45 Median $0.48 Typical High $0.51 | Professional | JW · Drug discarded | $0.45 | $0.48 | $0.51 |
Where Michigan sits
The same service costs 2.5 times more in Texas than in Tennessee. 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· 13th of 51
$2.24
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.