How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.14 Median $0.39 Typical High $0.44 | Facility | None | $0.14 | $0.39 | $0.44 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | None | $0.14 | $0.14 | $0.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 52 · Reduced service | $0.07 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.14 Median $0.39 Typical High $0.44 | Facility | None | $0.14 | $0.39 | $0.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.11 Median $0.14 Typical High $0.16 | Professional | None | $0.11 | $0.14 | $0.16 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.07 | $0.07 | $0.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Priority Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.72 Typical High $0.76 | Professional | None | $0.28 | $0.72 | $0.76 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.04 Typical High $10.00 | Professional | 56 · Pre-op care only | $0.02 | $0.04 | $10.00 |
Where Michigan sits
The same service costs 12.9 times more in Kansas than in Michigan. 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· 51st of 51
$0.14
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.