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 $3.31 Median $9.33 Typical High $10.47 | Facility | None | $3.31 | $9.33 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $10.47 | Professional | None | $3.24 | $3.31 | $10.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.47 Median $6.76 Typical High $12.88 | Facility | None | $3.47 | $6.76 | $12.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.16 Median $3.31 Typical High $3.63 | Professional | None | $3.16 | $3.31 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | None | $3.24 | $3.31 | $3.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.55 Median $8.71 Typical High $10.47 | Facility | None | $3.55 | $8.71 | $10.47 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $4.37 | Professional | None | $3.24 | $3.39 | $4.37 |
Priority Health Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | None | $3.24 | $3.31 | $3.31 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | None | $3.24 | $3.24 | $4.37 |
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 $1.62 Median $1.66 Typical High $5.25 | Professional | 52 · Reduced service | $1.62 | $1.66 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.68 Typical High $2.09 | Professional | 53 · Discontinued | $0.65 | $0.68 | $2.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.51 Typical High $7.76 | Professional | 54 · Surgery only | $2.45 | $2.51 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.50 Typical High $1.55 | Professional | 55 · Aftercare only | $0.49 | $0.50 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.33 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.32 | $0.33 | $1.05 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.95 Median $3.09 Typical High $3.24 | Professional | JW · Drug discarded | $2.95 | $3.09 | $3.24 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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
$3.31
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.