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 $2.24 Median $6.31 Typical High $7.08 | Facility | None | $2.24 | $6.31 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | None | $2.19 | $2.24 | $2.24 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.29 Median $4.57 Typical High $8.71 | Facility | None | $2.29 | $4.57 | $8.71 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $2.45 | Professional | None | $2.14 | $2.24 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.16 Median $5.89 Typical High $7.08 | Facility | None | $3.16 | $5.89 | $7.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.19 Median $2.29 Typical High $2.95 | Professional | None | $2.19 | $2.29 | $2.95 |
Priority Health Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
United Setting Facility Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.95 | Professional | None | $2.19 | $2.19 | $2.95 |
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 $1.10 Median $1.12 Typical High $3.55 | Professional | 52 · Reduced service | $1.10 | $1.12 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.45 Typical High $1.41 | Professional | 53 · Discontinued | $0.44 | $0.45 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.34 Typical High $1.07 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.71 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.00 Median $2.09 Typical High $2.19 | Professional | JW · Drug discarded | $2.00 | $2.09 | $2.19 |
Where Michigan sits
The same service costs 1.9 times more in Alaska than in New York. 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· 32nd of 51
$2.24
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.