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 $5.62 Median $15.14 Typical High $16.98 | Facility | None | $5.62 | $15.14 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.62 Typical High $7.08 | Professional | None | $5.50 | $5.62 | $7.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.89 Median $11.48 Typical High $21.88 | Facility | None | $5.89 | $11.48 | $21.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.37 Median $5.62 Typical High $6.17 | Professional | None | $5.37 | $5.62 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | None | $4.47 | $4.47 | $5.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.89 Median $14.79 Typical High $16.98 | Facility | None | $5.89 | $14.79 | $16.98 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $7.41 | Professional | None | $5.50 | $5.50 | $7.41 |
Priority Health Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | None | $4.47 | $4.47 | $5.50 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $7.08 | Professional | None | $5.37 | $5.37 | $7.08 |
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 $2.75 Median $2.82 Typical High $3.47 | Professional | 52 · Reduced service | $2.75 | $2.82 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.12 Typical High $1.41 | Professional | 53 · Discontinued | $1.10 | $1.12 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.85 Typical High $1.05 | Professional | 55 · Aftercare only | $0.83 | $0.85 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.56 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.55 | $0.56 | $0.71 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $5.01 Median $5.25 Typical High $5.50 | Professional | JW · Drug discarded | $5.01 | $5.25 | $5.50 |
Where Michigan sits
The same service costs 1.7 times more in Alaska than in Nebraska. 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· 19th of 51
$5.62
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.