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 $4.79 Median $12.88 Typical High $14.45 | Facility | None | $4.79 | $12.88 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.79 Typical High $6.03 | Professional | None | $4.68 | $4.79 | $6.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.01 Median $9.77 Typical High $18.62 | Facility | None | $5.01 | $9.77 | $18.62 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $5.25 | Professional | None | $4.47 | $4.79 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.68 | Professional | None | $4.17 | $4.17 | $4.68 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.01 Median $12.59 Typical High $14.45 | Facility | None | $5.01 | $12.59 | $14.45 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | None | $4.68 | $4.68 | $6.31 |
Priority Health Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.68 | Professional | None | $4.17 | $4.17 | $4.68 |
United Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $6.03 | Professional | None | $4.47 | $4.47 | $6.03 |
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 $2.34 Median $2.40 Typical High $3.02 | Professional | 52 · Reduced service | $2.34 | $2.40 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.95 Typical High $1.20 | Professional | 53 · Discontinued | $0.93 | $0.95 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.72 Typical High $0.89 | Professional | 55 · Aftercare only | $0.71 | $0.72 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.48 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.47 | $0.48 | $0.60 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $4.27 Median $4.47 Typical High $4.68 | Professional | JW · Drug discarded | $4.27 | $4.47 | $4.68 |
Where Michigan sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 18th of 51
$4.79
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.