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 $0.14 Median $0.15 Typical High $0.47 | Facility | None | $0.14 | $0.15 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $0.21 | Professional | None | $0.14 | $0.15 | $0.21 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.15 Median $0.28 Typical High $0.56 | Facility | None | $0.15 | $0.28 | $0.56 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | None | $0.02 | $0.02 | $0.03 |
Cigna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | None | $0.12 | $0.12 | $0.14 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.37 Median $1.91 Typical High $7.24 | Facility | None | $0.37 | $1.91 | $7.24 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.14 Median $0.17 Typical High $0.25 | Professional | None | $0.14 | $0.17 | $0.25 |
Priority Health Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | None | $0.12 | $0.12 | $0.14 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.23 | Professional | None | $0.17 | $0.17 | $0.23 |
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 $0.07 Median $0.08 Typical High $0.27 | Professional | 52 · Reduced service | $0.07 | $0.08 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.11 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.08 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.10 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | JW · Drug discarded | $0.02 | $0.02 | $0.03 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $1.00 Median $5.62 Typical High $9.77 | Facility | JZ · No drug discarded | $1.00 | $5.62 | $9.77 |
Where Michigan sits
The same service costs 4.4 times more in Michigan 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· 1st of 51
$0.62
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.