How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $10Professionalmedian $2 · 10th to 90th $1 to $3
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 $2.09 Median $2.14 Typical High $6.61 | Facility | None | $2.09 | $2.14 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | None | $2.09 | $2.09 | $2.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | 52 · Reduced service | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $2.04 Typical High $3.98 | Professional | None | $1.74 | $2.04 | $3.98 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.09 Median $4.17 Typical High $8.13 | Facility | None | $2.09 | $4.17 | $8.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.78 Median $0.81 Typical High $0.81 | Professional | None | $0.78 | $0.81 | $0.81 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.72 Median $0.76 Typical High $0.76 | Professional | JW · Drug discarded | $0.72 | $0.76 | $0.76 |
CareSource Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.69 | Professional | None | $2.00 | $2.00 | $2.69 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.29 Typical High $3.47 | Professional | None | $2.09 | $2.29 | $3.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.09 Median $5.89 Typical High $9.55 | Facility | None | $2.09 | $5.89 | $9.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.04 Median $2.14 Typical High $2.82 | Professional | None | $2.04 | $2.14 | $2.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.42 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.32 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Priority Health Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $3.47 | Professional | None | $2.09 | $2.09 | $3.47 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.63 Typical High $2.82 | Professional | None | $2.04 | $2.63 | $2.82 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | JZ · No drug discarded | $2.04 | $2.04 | $2.04 |
Where Michigan sits
The same service costs 2.1 times more in Wyoming than in Delaware. 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· 28th of 51
$2.09
WY $4.37DE $2.04
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.