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 $3.02 Median $3.09 Typical High $8.71 | Facility | None | $3.02 | $3.09 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Professional | None | $3.02 | $3.02 | $3.16 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.24 Median $6.31 Typical High $12.02 | Facility | None | $3.24 | $6.31 | $12.02 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.48 Median $0.50 Typical High $0.50 | Professional | None | $0.48 | $0.50 | $0.50 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.45 Median $0.47 Typical High $0.47 | Professional | JW · Drug discarded | $0.45 | $0.47 | $0.47 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $2.95 | Professional | None | $2.57 | $2.95 | $2.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.02 Median $7.24 Typical High $8.71 | Facility | None | $3.02 | $7.24 | $8.71 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.75 Median $2.95 Typical High $3.89 | Professional | None | $2.75 | $2.95 | $3.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | 52 · Reduced service | $1.38 | $1.38 | $1.38 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 53 · Discontinued | $0.55 | $0.55 | $0.55 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.41 | $0.41 | $0.41 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Priority Health Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.95 | Professional | None | $2.57 | $2.57 | $2.95 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $3.16 | Professional | None | $2.69 | $2.95 | $3.16 |
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 $2.69 Median $2.69 Typical High $2.69 | Professional | JZ · No drug discarded | $2.69 | $2.69 | $2.69 |
Where Michigan sits
Rates are fairly even across states for this service. 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· 42nd of 51
$2.95
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.