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 $2.24 Median $2.24 Typical High $7.08 | Facility | None | $2.24 | $2.24 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $3.02 | Professional | None | $2.19 | $2.24 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $2.19 | Professional | None | $1.86 | $2.19 | $2.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.29 Median $4.57 Typical High $8.71 | Facility | None | $2.29 | $4.57 | $8.71 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.48 Median $0.51 Typical High $0.56 | Professional | None | $0.48 | $0.51 | $0.56 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.51 Typical High $2.51 | Professional | None | $2.19 | $2.51 | $2.51 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.63 Median $7.94 Typical High $17.78 | Facility | None | $2.63 | $7.94 | $17.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.19 Median $2.40 Typical High $4.07 | Professional | None | $2.19 | $2.40 | $4.07 |
Priority Health Setting Professional Modifier None Typical Low $2.19 Median $2.51 Typical High $2.51 | Professional | None | $2.19 | $2.51 | $2.51 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.45 | Professional | None | $2.19 | $2.19 | $2.45 |
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 $1.10 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.10 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.45 Typical High $0.52 | Professional | 53 · Discontinued | $0.44 | $0.45 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.34 Typical High $0.39 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.26 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.45 Median $0.48 Typical High $0.51 | Professional | JW · Drug discarded | $0.45 | $0.48 | $0.51 |
Where Michigan sits
The same service costs 2.7 times more in Wyoming than in Nevada. 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· 12th of 51
$2.69
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.