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 $0.62 Median $1.78 Typical High $2.00 | Facility | None | $0.62 | $1.78 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.62 Typical High $0.76 | Professional | None | $0.60 | $0.62 | $0.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.63 Median $1.23 Typical High $2.40 | Facility | None | $0.63 | $1.23 | $2.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.22 Median $0.23 Typical High $0.25 | Professional | None | $0.22 | $0.23 | $0.25 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.81 Typical High $0.81 | Professional | None | $0.60 | $0.81 | $0.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.87 Median $1.78 Typical High $2.04 | Facility | None | $0.87 | $1.78 | $2.04 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.60 Median $0.65 Typical High $0.91 | Professional | None | $0.60 | $0.65 | $0.91 |
Priority Health Setting Professional Modifier None Typical Low $0.60 Median $0.81 Typical High $0.83 | Professional | None | $0.60 | $0.81 | $0.83 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.69 Typical High $0.89 | Professional | None | $0.62 | $0.69 | $0.89 |
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 $0.30 Median $0.31 Typical High $1.00 | Professional | 52 · Reduced service | $0.30 | $0.31 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.40 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.30 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.20 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.21 Median $0.22 Typical High $0.23 | Professional | JW · Drug discarded | $0.21 | $0.22 | $0.23 |
Where Michigan sits
The same service costs 3.4 times more in Wyoming 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· 14th of 51
$0.69
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.