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 $4.68 Median $4.79 Typical High $13.49 | Facility | None | $4.68 | $4.79 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | None | $4.47 | $4.68 | $4.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.79 Median $9.33 Typical High $17.78 | Facility | None | $4.79 | $9.33 | $17.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.75 Median $2.88 Typical High $3.24 | Professional | None | $2.75 | $2.88 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $9.33 Typical High $9.33 | Professional | None | $4.47 | $9.33 | $9.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $6.03 Median $15.49 Typical High $33.11 | Facility | None | $6.03 | $15.49 | $33.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.37 Median $4.68 Typical High $7.08 | Professional | None | $4.37 | $4.68 | $7.08 |
Priority Health Setting Professional Modifier None Typical Low $4.47 Median $9.33 Typical High $9.33 | Professional | None | $4.47 | $9.33 | $9.33 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.62 | Professional | None | $4.17 | $4.17 | $5.62 |
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 $2.24 Median $2.29 Typical High $6.76 | Professional | 52 · Reduced service | $2.24 | $2.29 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.93 Typical High $2.69 | Professional | 53 · Discontinued | $0.89 | $0.93 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.71 Typical High $2.04 | Professional | 55 · Aftercare only | $0.68 | $0.71 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $1.35 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.57 Median $2.75 Typical High $2.88 | Professional | JW · Drug discarded | $2.57 | $2.75 | $2.88 |
Where Michigan sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 10th of 51
$5.37
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.