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 $0.66 Median $0.68 Typical High $2.19 | Facility | None | $0.66 | $0.68 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $0.65 Median $0.66 Typical High $0.83 | Professional | None | $0.65 | $0.66 | $0.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.68 Median $1.32 Typical High $2.57 | Facility | None | $0.68 | $1.32 | $2.57 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.24 Median $0.25 Typical High $0.28 | Professional | None | $0.24 | $0.25 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $1.07 Typical High $1.07 | Professional | None | $0.65 | $1.07 | $1.07 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.68 Median $1.82 Typical High $3.63 | Facility | None | $0.68 | $1.82 | $3.63 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.65 Median $0.71 Typical High $1.00 | Professional | None | $0.65 | $0.71 | $1.00 |
Priority Health Setting Professional Modifier None Typical Low $0.65 Median $1.07 Typical High $1.07 | Professional | None | $0.65 | $1.07 | $1.07 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.91 | Professional | None | $0.68 | $0.68 | $0.91 |
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 $0.32 Median $0.33 Typical High $0.38 | Professional | 52 · Reduced service | $0.32 | $0.33 | $0.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.15 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.08 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.23 Median $0.24 Typical High $0.24 | Professional | JW · Drug discarded | $0.23 | $0.24 | $0.24 |
Where Michigan sits
The same service costs 2.6 times more in Texas than in Wyoming. 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· 18th of 51
$0.71
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.