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 $2.19 Median $6.03 Typical High $6.76 | Facility | None | $2.19 | $6.03 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $2.95 | Professional | None | $2.14 | $2.19 | $2.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.29 Median $4.47 Typical High $8.51 | Facility | None | $2.29 | $4.47 | $8.51 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $2.40 | Professional | None | $2.04 | $2.19 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.14 | Professional | None | $1.51 | $1.51 | $2.14 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.29 Median $5.75 Typical High $6.76 | Facility | None | $2.29 | $5.75 | $6.76 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $2.88 | Professional | None | $2.14 | $2.19 | $2.88 |
Priority Health Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.14 | Professional | None | $1.51 | $1.51 | $2.14 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.82 | Professional | None | $2.14 | $2.14 | $2.82 |
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 $1.07 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.07 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 53 · Discontinued | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.32 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.95 Median $2.04 Typical High $2.14 | Professional | JW · Drug discarded | $1.95 | $2.04 | $2.14 |
Where Michigan sits
The same service costs 1.6 times more in Arizona than in Mississippi. 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· 21st of 51
$2.19
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.