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 $1.70 Median $1.74 Typical High $6.03 | Facility | None | $1.70 | $1.74 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.70 Typical High $1.82 | Professional | None | $1.66 | $1.70 | $1.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.74 Median $3.47 Typical High $6.76 | Facility | None | $1.74 | $3.47 | $6.76 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $0.87 | Professional | None | $0.76 | $0.79 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $1.91 | Professional | None | $1.66 | $1.91 | $1.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.78 Median $5.62 Typical High $12.59 | Facility | None | $1.78 | $5.62 | $12.59 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.66 Median $1.82 Typical High $2.29 | Professional | None | $1.66 | $1.82 | $2.29 |
Priority Health Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $1.91 | Professional | None | $1.66 | $1.91 | $1.91 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.09 | Professional | None | $1.86 | $1.86 | $2.09 |
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 $0.83 Median $0.85 Typical High $3.02 | Professional | 52 · Reduced service | $0.83 | $0.85 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.34 Typical High $1.20 | Professional | 53 · Discontinued | $0.33 | $0.34 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.26 Typical High $0.89 | Professional | 55 · Aftercare only | $0.25 | $0.26 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.60 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.71 Median $0.76 Typical High $0.79 | Professional | JW · Drug discarded | $0.71 | $0.76 | $0.79 |
Where Michigan sits
The same service costs 3.2 times more in Texas than in Georgia. 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· 20th of 51
$1.91
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.