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 $5.50 Median $5.62 Typical High $15.85 | Facility | None | $5.50 | $5.62 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.50 Median $10.72 Typical High $20.42 | Facility | None | $5.50 | $10.72 | $20.42 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.31 Median $0.33 Typical High $0.33 | Professional | None | $0.31 | $0.33 | $0.33 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.28 Median $0.31 Typical High $0.31 | Professional | JW · Drug discarded | $0.28 | $0.31 | $0.31 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.12 | Professional | None | $6.76 | $6.76 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.37 | Professional | None | $5.25 | $5.25 | $5.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.50 Median $14.13 Typical High $23.99 | Facility | None | $5.50 | $14.13 | $23.99 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $7.08 | Professional | None | $5.13 | $5.25 | $7.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $1.02 | $1.02 | $1.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
Priority Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.37 | Professional | None | $5.25 | $5.25 | $5.37 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.50 Typical High $5.89 | Professional | None | $4.90 | $5.50 | $5.89 |
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 $4.90 Median $5.25 Typical High $5.89 | Professional | JZ · No drug discarded | $4.90 | $5.25 | $5.89 |
Where Michigan sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 36th of 51
$5.25
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.