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 $1.38 Median $3.80 Typical High $4.27 | Facility | None | $1.38 | $3.80 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.38 Typical High $1.38 | Professional | None | $1.32 | $1.38 | $1.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.41 Median $2.75 Typical High $5.25 | Facility | None | $1.41 | $2.75 | $5.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.29 Median $1.35 Typical High $1.48 | Professional | None | $1.29 | $1.35 | $1.48 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.32 | Professional | None | $1.00 | $1.00 | $1.32 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.41 Median $3.63 Typical High $4.27 | Facility | None | $1.41 | $3.63 | $4.27 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.32 Median $1.35 Typical High $1.78 | Professional | None | $1.32 | $1.35 | $1.78 |
Priority Health Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.32 | Professional | None | $1.00 | $1.00 | $1.32 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.78 | Professional | None | $1.32 | $1.32 | $1.78 |
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 $0.68 Median $0.69 Typical High $0.69 | Professional | 52 · Reduced service | $0.68 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.14 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.20 Median $1.26 Typical High $1.32 | Professional | JW · Drug discarded | $1.20 | $1.26 | $1.32 |
Where Michigan sits
The same service costs 1.5 times more in Alaska than in Virginia. 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
$1.35
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.