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 $0.08 Median $0.09 Typical High $0.25 | Facility | None | $0.08 | $0.09 | $0.25 |
Aetna Setting Professional Modifier None Typical Low $0.08 Median $0.09 Typical High $0.13 | Professional | None | $0.08 | $0.09 | $0.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.09 Median $0.18 Typical High $0.36 | Facility | None | $0.09 | $0.18 | $0.36 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | None | $0.04 | $0.04 | $0.05 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | None | $0.09 | $0.11 | $0.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.21 Median $0.63 Typical High $5.50 | Facility | None | $0.21 | $0.63 | $5.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.23 | Professional | None | $0.09 | $0.09 | $0.23 |
Priority Health Setting Professional Modifier None Typical Low $0.09 Median $0.11 Typical High $0.11 | Professional | None | $0.09 | $0.11 | $0.11 |
United Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.12 | Professional | None | $0.09 | $0.09 | $0.12 |
6 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 $0.05 Median $0.05 Typical High $0.14 | Professional | 52 · Reduced service | $0.05 | $0.05 | $0.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.06 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.06 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | JW · Drug discarded | $8.91 | $8.91 | $8.91 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | JW · Drug discarded | $0.04 | $0.04 | $0.05 |
Health Alliance Plan Setting Facility Modifier JW · Drug discarded Typical Low $0.16 Median $1.45 Typical High $3.09 | Facility | JW · Drug discarded | $0.16 | $1.45 | $3.09 |
Health Alliance Plan Setting Facility Modifier U6 · State-defined Typical Low $0.98 Median $5.50 Typical High $6.61 | Facility | U6 · State-defined | $0.98 | $5.50 | $6.61 |
Where Michigan sits
The same service costs 14.5 times more in Alaska than in New Jersey. 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· 3rd of 51
$0.32
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.