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 $2.24 Median $2.29 Typical High $7.76 | Facility | None | $2.24 | $2.29 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $2.45 | Professional | None | $2.19 | $2.24 | $2.45 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.29 Median $4.57 Typical High $8.71 | Facility | None | $2.29 | $4.57 | $8.71 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.72 Median $0.76 Typical High $0.83 | Professional | None | $0.72 | $0.76 | $0.83 |
Cigna Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.19 | Professional | None | $1.70 | $1.70 | $2.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.24 Median $6.46 Typical High $15.85 | Facility | None | $2.24 | $6.46 | $15.85 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $3.02 | Professional | None | $2.19 | $2.40 | $3.02 |
Priority Health Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.19 | Professional | None | $1.70 | $1.70 | $2.19 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $3.24 | Professional | None | $2.40 | $2.40 | $3.24 |
3 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 55 · Aftercare only Typical Low $0.33 Median $0.34 Typical High $1.15 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.78 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.68 Median $0.71 Typical High $0.76 | Professional | JW · Drug discarded | $0.68 | $0.71 | $0.76 |
Where Michigan sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 27th of 51
$2.40
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.