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 $2.00 Median $2.40 Typical High $2.69 | Facility | None | $2.00 | $2.40 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $2.00 Typical High $2.69 | Professional | None | $1.95 | $2.00 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.30 Typical High $0.41 | Professional | 55 · Aftercare only | $0.28 | $0.30 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.20 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.19 | $0.20 | $0.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.04 Median $4.07 Typical High $7.59 | Facility | None | $2.04 | $4.07 | $7.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.02 Median $1.07 Typical High $1.07 | Professional | None | $1.02 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $1.95 | Professional | None | $0.69 | $0.69 | $1.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.10 Median $2.69 Typical High $5.75 | Facility | None | $1.10 | $2.69 | $5.75 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.87 Median $1.95 Typical High $2.29 | Professional | None | $0.87 | $1.95 | $2.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Priority Health Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $1.95 | Professional | None | $0.69 | $0.69 | $1.95 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.91 Typical High $0.98 | Professional | None | $0.36 | $0.91 | $0.98 |
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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | JW · Drug discarded | $0.95 | $1.00 | $1.00 |
Where Michigan sits
The same service costs 2.3 times more in Arkansas than in North Carolina. 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· 41st of 51
$1.55
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.