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 $1.12 Median $3.39 Typical High $3.80 | Facility | None | $1.12 | $3.39 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | None | $1.10 | $1.12 | $1.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.15 Median $2.29 Typical High $4.37 | Facility | None | $1.15 | $2.29 | $4.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.51 Median $0.54 Typical High $0.59 | Professional | None | $0.51 | $0.54 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.86 Typical High $1.86 | Professional | None | $1.10 | $1.86 | $1.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.00 Median $2.95 Typical High $3.80 | Facility | None | $2.00 | $2.95 | $3.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.10 Median $1.23 Typical High $1.70 | Professional | None | $1.10 | $1.23 | $1.70 |
Priority Health Setting Professional Modifier None Typical Low $1.10 Median $1.86 Typical High $1.86 | Professional | None | $1.10 | $1.86 | $1.86 |
United Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.58 | Professional | None | $1.17 | $1.17 | $1.58 |
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 $0.55 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.55 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.22 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.32 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.38 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.48 Median $0.51 Typical High $0.54 | Professional | JW · Drug discarded | $0.48 | $0.51 | $0.54 |
Where Michigan sits
The same service costs 3.0 times more in Oklahoma than in Delaware. 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· 24th of 51
$1.23
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.