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 $1.26 Median $1.29 Typical High $3.24 | Facility | None | $1.26 | $1.29 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.26 Typical High $1.58 | Professional | None | $1.23 | $1.26 | $1.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.29 Median $2.51 Typical High $4.79 | Facility | None | $1.29 | $2.51 | $4.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.44 Median $0.46 Typical High $0.51 | Professional | None | $0.44 | $0.46 | $0.51 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.91 Typical High $1.91 | Professional | None | $1.23 | $1.91 | $1.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.32 Median $5.13 Typical High $8.71 | Facility | None | $1.32 | $5.13 | $8.71 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.12 Median $1.29 Typical High $1.74 | Professional | None | $1.12 | $1.29 | $1.74 |
Priority Health Setting Professional Modifier None Typical Low $1.23 Median $1.91 Typical High $1.91 | Professional | None | $1.23 | $1.91 | $1.91 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.45 | Professional | None | $1.10 | $1.10 | $1.45 |
7 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 $0.62 Median $0.63 Typical High $0.68 | Professional | 52 · Reduced service | $0.62 | $0.63 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.25 Typical High $0.71 | Professional | 53 · Discontinued | $0.24 | $0.25 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.19 Typical High $0.52 | Professional | 55 · Aftercare only | $0.18 | $0.19 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.13 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.12 | $0.13 | $0.35 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | JZ · No drug discarded | $1.10 | $1.10 | $1.10 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.41 Median $0.43 Typical High $0.45 | Professional | JW · Drug discarded | $0.41 | $0.43 | $0.45 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $2.45 Median $8.13 Typical High $8.91 | Facility | JZ · No drug discarded | $2.45 | $8.13 | $8.91 |
Where Michigan sits
The same service costs 3.8 times more in Texas than in Maryland. 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· 7th of 51
$1.62
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.