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 $2.88 Median $2.95 Typical High $9.55 | Facility | None | $2.88 | $2.95 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.88 Typical High $9.55 | Professional | None | $2.82 | $2.88 | $9.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.02 Median $5.89 Typical High $11.22 | Facility | None | $3.02 | $5.89 | $11.22 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.30 Median $0.32 Typical High $0.35 | Professional | None | $0.30 | $0.32 | $0.35 |
Cigna Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.82 | Professional | None | $1.70 | $1.70 | $2.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.45 Median $8.32 Typical High $23.44 | Facility | None | $2.45 | $8.32 | $23.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.82 Median $3.02 Typical High $4.17 | Professional | None | $2.82 | $3.02 | $4.17 |
Priority Health Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $2.82 | Professional | None | $1.70 | $1.70 | $2.82 |
United Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.98 | Professional | None | $2.95 | $2.95 | $3.98 |
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 $1.41 Median $1.45 Typical High $4.79 | Professional | 52 · Reduced service | $1.41 | $1.45 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.58 Typical High $1.91 | Professional | 53 · Discontinued | $0.56 | $0.58 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.44 Typical High $1.45 | Professional | 55 · Aftercare only | $0.42 | $0.44 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.95 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.28 Median $0.30 Typical High $0.32 | Professional | JW · Drug discarded | $0.28 | $0.30 | $0.32 |
Where Michigan sits
The same service costs 7.4 times more in Wyoming than in Kansas. 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· 24th of 51
$2.95
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.