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 $0.79 Median $2.45 Typical High $2.75 | Facility | None | $0.79 | $2.45 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $0.79 | Professional | None | $0.76 | $0.79 | $0.79 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.79 Median $1.58 Typical High $3.09 | Facility | None | $0.79 | $1.58 | $3.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.33 Median $0.35 Typical High $0.39 | Professional | None | $0.33 | $0.35 | $0.39 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $1.41 Typical High $1.41 | Professional | None | $0.76 | $1.41 | $1.41 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.20 Median $2.24 Typical High $3.55 | Facility | None | $1.20 | $2.24 | $3.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.76 Median $0.87 Typical High $1.15 | Professional | None | $0.76 | $0.87 | $1.15 |
Priority Health Setting Professional Modifier None Typical Low $0.76 Median $1.41 Typical High $1.41 | Professional | None | $0.76 | $1.41 | $1.41 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.12 | Professional | None | $0.85 | $0.85 | $1.12 |
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 $0.38 Median $0.40 Typical High $1.38 | Professional | 52 · Reduced service | $0.38 | $0.40 | $1.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.16 Typical High $0.55 | Professional | 53 · Discontinued | $0.15 | $0.16 | $0.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.12 Typical High $0.41 | Professional | 55 · Aftercare only | $0.11 | $0.12 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.27 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.31 Median $0.33 Typical High $0.35 | Professional | JW · Drug discarded | $0.31 | $0.33 | $0.35 |
Where Michigan sits
The same service costs 3.9 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· 16th of 51
$0.85
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.