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 $3.55 Median $9.33 Typical High $10.47 | Facility | None | $3.55 | $9.33 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $3.55 | Professional | None | $3.47 | $3.55 | $3.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.63 Median $7.24 Typical High $13.80 | Facility | None | $3.63 | $7.24 | $13.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.31 Median $3.55 Typical High $3.89 | Professional | None | $3.31 | $3.55 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.47 | Professional | None | $2.95 | $2.95 | $3.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.72 Median $9.33 Typical High $10.47 | Facility | None | $3.72 | $9.33 | $10.47 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.39 Median $3.47 Typical High $4.68 | Professional | None | $3.39 | $3.47 | $4.68 |
Priority Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.47 | Professional | None | $2.95 | $2.95 | $3.47 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | None | $3.24 | $3.24 | $4.37 |
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 $1.74 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.35 | $0.36 | $0.36 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $3.16 Median $3.31 Typical High $3.47 | Professional | JW · Drug discarded | $3.16 | $3.31 | $3.47 |
Where Michigan sits
The same service costs 2.1 times more in Alaska 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· 17th of 51
$3.55
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.