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 $2.63 Median $7.08 Typical High $7.94 | Facility | None | $2.63 | $7.08 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.63 Typical High $2.63 | Professional | None | $2.57 | $2.63 | $2.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.75 Median $5.37 Typical High $10.23 | Facility | None | $2.75 | $5.37 | $10.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $2.88 | Professional | None | $2.51 | $2.63 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.57 | Professional | None | $2.14 | $2.14 | $2.57 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.75 Median $6.92 Typical High $7.94 | Facility | None | $2.75 | $6.92 | $7.94 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.51 Median $2.57 Typical High $3.47 | Professional | None | $2.51 | $2.57 | $3.47 |
Priority Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.57 | Professional | None | $2.14 | $2.14 | $2.57 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.31 | Professional | None | $2.45 | $2.45 | $3.31 |
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 $1.29 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $1.29 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 54 · Surgery only | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.39 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.26 | $0.27 | $0.27 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.34 Median $2.45 Typical High $2.57 | Professional | JW · Drug discarded | $2.34 | $2.45 | $2.57 |
Where Michigan sits
The same service costs 1.8 times more in Alaska than in Maryland. 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· 22nd of 51
$2.63
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.