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 $3.16 Median $9.33 Typical High $10.47 | Facility | None | $3.16 | $9.33 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $9.77 | Professional | None | $3.02 | $3.16 | $9.77 |
BCBS Michigan Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $19.95 | Professional | None | $17.38 | $18.20 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $6.92 Typical High $6.92 | Professional | None | $3.02 | $6.92 | $6.92 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.08 Median $8.91 Typical High $21.88 | Facility | None | $7.08 | $8.91 | $21.88 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $6.31 | Professional | None | $3.02 | $3.39 | $6.31 |
Priority Health Setting Professional Modifier None Typical Low $3.02 Median $6.92 Typical High $6.92 | Professional | None | $3.02 | $6.92 | $6.92 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.37 | Professional | None | $3.24 | $3.24 | $4.37 |
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 $1.51 Median $1.58 Typical High $5.01 | Professional | 52 · Reduced service | $1.51 | $1.58 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.63 Typical High $2.00 | Professional | 53 · Discontinued | $0.62 | $0.63 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.47 Typical High $1.51 | Professional | 55 · Aftercare only | $0.46 | $0.47 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.31 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.30 | $0.31 | $1.00 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $16.22 Median $16.98 Typical High $17.78 | Professional | JW · Drug discarded | $16.22 | $16.98 | $17.78 |
Where Michigan sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 20th of 51
$3.63
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.