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 $0.11 Median $0.12 Typical High $0.47 | Facility | None | $0.11 | $0.12 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.11 Median $0.12 Typical High $0.12 | Professional | None | $0.11 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
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 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
BCBS Setting Facility Modifier None Typical Low $0.11 Median $0.23 Typical High $0.44 | Facility | None | $0.11 | $0.23 | $0.44 |
BCBS Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
BCBS Setting Professional Modifier JW · Drug discarded Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | JW · Drug discarded | $0.06 | $0.06 | $0.06 |
CareSource Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.19 | Professional | None | $0.14 | $0.14 | $0.19 |
Cigna Setting Professional Modifier None Typical Low $0.11 Median $0.11 Typical High $0.13 | Professional | None | $0.11 | $0.11 | $0.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.14 Median $0.42 Typical High $1.38 | Facility | None | $0.14 | $0.42 | $1.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.11 Median $0.14 Typical High $0.15 | Professional | None | $0.11 | $0.14 | $0.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
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 $0.11 Median $0.13 Typical High $0.13 | Professional | None | $0.11 | $0.13 | $0.13 |
United Setting Professional Modifier None Typical Low $0.15 Median $1.32 Typical High $1.38 | Professional | None | $0.15 | $1.32 | $1.38 |
2 more rates 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 $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.02 | $0.20 | $0.20 |
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 |
Where Michigan sits
The same service costs 3.1 times more in Wyoming than in Alabama. 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· 39th of 51
$0.12
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.