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 $1.41 Median $1.45 Typical High $3.31 | Facility | None | $1.41 | $1.45 | $3.31 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.45 Typical High $1.82 | Professional | None | $1.38 | $1.45 | $1.82 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | JZ · No drug discarded | $1.15 | $1.15 | $1.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.48 Median $2.88 Typical High $5.50 | Facility | None | $1.48 | $2.88 | $5.50 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.32 Median $0.34 Typical High $0.37 | Professional | None | $0.32 | $0.34 | $0.37 |
Cigna Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.38 | Professional | None | $0.91 | $0.91 | $1.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.66 Median $4.07 Typical High $9.12 | Facility | None | $1.66 | $4.07 | $9.12 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $3.24 Median $4.90 Typical High $8.13 | Facility | JZ · No drug discarded | $3.24 | $4.90 | $8.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.15 Median $1.41 Typical High $2.09 | Professional | None | $1.15 | $1.41 | $2.09 |
Priority Health Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.38 | Professional | None | $0.91 | $0.91 | $1.38 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.55 | Professional | None | $1.15 | $1.15 | $1.55 |
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 $0.71 Median $0.72 Typical High $0.72 | Professional | 52 · Reduced service | $0.71 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.30 Median $0.32 Typical High $0.34 | Professional | JW · Drug discarded | $0.30 | $0.32 | $0.34 |
Where Michigan sits
The same service costs 5.9 times more in Vermont than in Oklahoma. 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· 5th 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.