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 $2.34 Median $2.40 Typical High $7.94 | Facility | None | $2.34 | $2.40 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.34 Typical High $2.34 | Professional | None | $2.29 | $2.34 | $2.34 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.40 Median $4.68 Typical High $8.91 | Facility | None | $2.40 | $4.68 | $8.91 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.65 Median $0.68 Typical High $0.74 | Professional | None | $0.65 | $0.68 | $0.74 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $6.46 Typical High $6.46 | Professional | None | $2.29 | $6.46 | $6.46 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.57 Median $6.61 Typical High $15.14 | Facility | None | $2.57 | $6.61 | $15.14 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.29 Median $2.57 Typical High $3.55 | Professional | None | $2.29 | $2.57 | $3.55 |
Priority Health Setting Professional Modifier None Typical Low $2.29 Median $6.46 Typical High $6.46 | Professional | None | $2.29 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | None | $2.45 | $2.45 | $3.31 |
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 $1.12 Median $1.17 Typical High $1.17 | Professional | 52 · Reduced service | $1.12 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.47 Typical High $1.58 | Professional | 53 · Discontinued | $0.45 | $0.47 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.35 Typical High $1.20 | Professional | 55 · Aftercare only | $0.34 | $0.35 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.79 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.60 Median $0.63 Typical High $0.66 | Professional | JW · Drug discarded | $0.60 | $0.63 | $0.66 |
Where Michigan sits
The same service costs 4.8 times more in Oklahoma than in Georgia. 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· 25th of 51
$2.51
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.