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 $2.00 Typical High $6.92 | Facility | None | $1.95 | $2.00 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $2.14 | Professional | None | $1.91 | $1.95 | $2.14 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.04 Median $3.98 Typical High $7.76 | Facility | None | $2.04 | $3.98 | $7.76 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.39 Median $0.41 Typical High $0.45 | Professional | None | $0.39 | $0.41 | $0.45 |
Cigna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $1.91 | Professional | None | $0.22 | $0.22 | $1.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.95 Median $3.80 Typical High $8.32 | Facility | None | $1.95 | $3.80 | $8.32 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.91 Median $2.14 Typical High $2.69 | Professional | None | $1.91 | $2.14 | $2.69 |
Priority Health Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $1.91 | Professional | None | $0.22 | $0.22 | $1.91 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.88 | Professional | None | $2.14 | $2.14 | $2.88 |
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 $0.95 Median $1.00 Typical High $3.47 | Professional | 52 · Reduced service | $0.95 | $1.00 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.39 Typical High $1.38 | Professional | 53 · Discontinued | $0.38 | $0.39 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.30 Typical High $1.05 | Professional | 55 · Aftercare only | $0.28 | $0.30 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.20 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.19 | $0.20 | $0.71 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.37 Median $0.39 Typical High $0.40 | Professional | JW · Drug discarded | $0.37 | $0.39 | $0.40 |
Where Michigan sits
The same service costs 2.5 times more in Texas than in South Carolina. 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· 40th 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.