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 $2.14 Median $5.62 Typical High $6.31 | Facility | None | $2.14 | $5.62 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.14 Typical High $6.31 | Professional | None | $2.09 | $2.14 | $6.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.19 Median $4.37 Typical High $8.32 | Facility | None | $2.19 | $4.37 | $8.32 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.82 Median $1.91 Typical High $2.09 | Professional | None | $1.82 | $1.91 | $2.09 |
Cigna Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $2.09 | Professional | None | $1.55 | $1.55 | $2.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.24 Median $5.62 Typical High $6.31 | Facility | None | $2.24 | $5.62 | $6.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $2.82 | Professional | None | $2.04 | $2.09 | $2.82 |
Priority Health Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $2.09 | Professional | None | $1.55 | $1.55 | $2.09 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.63 | Professional | None | $1.95 | $1.95 | $2.63 |
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 $1.05 Median $1.07 Typical High $3.16 | Professional | 52 · Reduced service | $1.05 | $1.07 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.43 Typical High $1.26 | Professional | 53 · Discontinued | $0.42 | $0.43 | $1.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.55 Median $1.62 Typical High $4.68 | Professional | 54 · Surgery only | $1.55 | $1.62 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.32 Typical High $0.95 | Professional | 55 · Aftercare only | $0.31 | $0.32 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.63 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.70 Median $1.78 Typical High $1.86 | Professional | JW · Drug discarded | $1.70 | $1.78 | $1.86 |
Where Michigan sits
The same service costs 1.6 times more in Alaska than in Iowa. 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· 39th of 51
$2.09
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.