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 $2.34 Typical High $4.79 | Facility | None | $2.34 | $2.34 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.34 Typical High $3.47 | Professional | None | $2.29 | $2.34 | $3.47 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.45 Median $4.79 Typical High $8.51 | Facility | None | $2.45 | $4.79 | $8.51 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.50 Median $0.52 Typical High $0.58 | Professional | None | $0.50 | $0.52 | $0.58 |
Cigna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $2.29 | Professional | None | $0.68 | $0.68 | $2.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.14 Median $4.47 Typical High $16.60 | Facility | None | $2.14 | $4.47 | $16.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.51 Median $2.29 Typical High $3.16 | Professional | None | $1.51 | $2.29 | $3.16 |
Priority Health Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $2.29 | Professional | None | $0.68 | $0.68 | $2.29 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.86 Typical High $2.40 | Professional | None | $1.66 | $1.86 | $2.40 |
6 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 $1.15 Median $1.20 Typical High $2.51 | Professional | 52 · Reduced service | $1.15 | $1.20 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.47 Typical High $1.00 | Professional | 53 · Discontinued | $0.46 | $0.47 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.36 Typical High $0.76 | Professional | 55 · Aftercare only | $0.35 | $0.36 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.24 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.23 | $0.24 | $0.50 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.47 Median $0.50 Typical High $0.52 | Professional | JW · Drug discarded | $0.47 | $0.50 | $0.52 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $2.51 Median $8.51 Typical High $19.50 | Facility | JZ · No drug discarded | $2.51 | $8.51 | $19.50 |
Where Michigan sits
The same service costs 3.8 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· 9th of 51
$2.40
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.