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 $3.39 Median $9.12 Typical High $10.23 | Facility | None | $3.39 | $9.12 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $10.23 | Professional | None | $3.24 | $3.39 | $10.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.47 Median $6.76 Typical High $12.88 | Facility | None | $3.47 | $6.76 | $12.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.51 Median $2.69 Typical High $2.95 | Professional | None | $2.51 | $2.69 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.24 | Professional | None | $2.14 | $2.14 | $3.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.47 Median $8.71 Typical High $10.23 | Facility | None | $3.47 | $8.71 | $10.23 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.47 | Professional | None | $3.24 | $3.24 | $4.47 |
Priority Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.24 | Professional | None | $2.14 | $2.14 | $3.24 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.27 | Professional | None | $3.16 | $3.16 | $4.27 |
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 $1.62 Median $1.70 Typical High $5.13 | Professional | 52 · Reduced service | $1.62 | $1.70 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.68 Typical High $2.04 | Professional | 53 · Discontinued | $0.65 | $0.68 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.50 Typical High $1.51 | Professional | 55 · Aftercare only | $0.49 | $0.50 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $1.02 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.40 Median $2.51 Typical High $2.63 | Professional | JW · Drug discarded | $2.40 | $2.51 | $2.63 |
Where Michigan sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 41st of 51
$3.24
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.