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 $0.21 Median $0.22 Typical High $0.66 | Facility | None | $0.21 | $0.22 | $0.66 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.27 | Professional | None | $0.20 | $0.21 | $0.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.11 Median $0.11 Typical High $5.01 | Professional | 52 · Reduced service | $0.11 | $0.11 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $2.00 | Professional | 53 · Discontinued | $0.04 | $0.04 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $1.51 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $1.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | None | $0.03 | $0.03 | $0.03 |
CareSource Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.41 | Professional | None | $0.13 | $0.13 | $0.41 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.30 Median $2.45 Typical High $5.89 | Facility | None | $0.30 | $2.45 | $5.89 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.16 Median $0.21 Typical High $0.34 | Professional | None | $0.16 | $0.21 | $0.34 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 52 · Reduced service | $0.11 | $0.11 | $0.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Priority Health Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.41 | Professional | None | $0.13 | $0.13 | $0.41 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.21 Typical High $0.23 | Professional | None | $0.08 | $0.21 | $0.23 |
1 more rate 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 |
|---|---|---|---|---|---|
Health Alliance Plan Setting Professional Modifier JZ · No drug discarded Typical Low $0.19 Median $0.19 Typical High $0.21 | Professional | JZ · No drug discarded | $0.19 | $0.19 | $0.21 |
Where Michigan sits
The same service costs 2.3 times more in Oklahoma than in Florida. 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· 16th of 51
$0.21
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.