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 $3.39 Median $3.47 Typical High $10.23 | Facility | None | $3.39 | $3.47 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $4.90 | Professional | None | $3.24 | $3.39 | $4.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.47 Median $6.76 Typical High $13.18 | Facility | None | $3.47 | $6.76 | $13.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.66 Median $0.71 Typical High $0.78 | Professional | None | $0.66 | $0.71 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $4.47 Typical High $4.47 | Professional | None | $3.24 | $4.47 | $4.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.39 Median $8.51 Typical High $11.75 | Facility | None | $3.39 | $8.51 | $11.75 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $4.57 | Professional | None | $3.24 | $3.39 | $4.57 |
Priority Health Setting Professional Modifier None Typical Low $3.24 Median $4.47 Typical High $4.47 | Professional | None | $3.24 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.27 | Professional | None | $3.16 | $3.16 | $4.27 |
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 $1.62 Median $1.70 Typical High $5.13 | Professional | 52 · Reduced service | $1.62 | $1.70 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.68 Typical High $2.04 | Professional | 53 · Discontinued | $0.65 | $0.68 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.50 Typical High $1.51 | Professional | 55 · Aftercare only | $0.49 | $0.50 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $1.00 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.62 Median $0.66 Typical High $0.71 | Professional | JW · Drug discarded | $0.62 | $0.66 | $0.71 |
Where Michigan sits
The same service costs 7.9 times more in Wyoming than in Louisiana. 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· 19th of 51
$3.39
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.