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 $3.47 Median $3.55 Typical High $100.00 | Facility | None | $3.47 | $3.55 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.47 Typical High $4.68 | Professional | None | $3.39 | $3.47 | $4.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.55 Median $7.08 Typical High $13.80 | Facility | None | $3.55 | $7.08 | $13.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.39 | Professional | None | $0.28 | $0.28 | $0.39 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $12.88 Typical High $12.88 | Professional | None | $3.39 | $12.88 | $12.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $6.61 Median $30.90 Typical High $114.82 | Facility | None | $6.61 | $30.90 | $114.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $31.62 | Professional | None | $3.39 | $3.80 | $31.62 |
Priority Health Setting Professional Modifier None Typical Low $3.39 Median $12.88 Typical High $12.88 | Professional | None | $3.39 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $30.90 Median $81.28 Typical High $89.13 | Professional | None | $30.90 | $81.28 | $89.13 |
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 $1.70 Median $1.74 Typical High $4.07 | Professional | 52 · Reduced service | $1.70 | $1.74 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.69 Typical High $10.72 | Professional | 53 · Discontinued | $0.68 | $0.69 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.52 Typical High $7.94 | Professional | 55 · Aftercare only | $0.50 | $0.52 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.35 Typical High $5.25 | Professional | 56 · Pre-op care only | $0.34 | $0.35 | $5.25 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | JZ · No drug discarded | $3.39 | $3.39 | $3.39 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.26 Median $0.27 Typical High $0.28 | Professional | JW · Drug discarded | $0.26 | $0.27 | $0.28 |
Where Michigan sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 23rd of 51
$7.41
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.