How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $10.96 Typical High $11.48 | Professional | None | $8.51 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $4.57 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $1.82 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.38 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.91 | $1.12 | $1.12 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $4.68 Typical High $10.23 | Professional | None | $3.72 | $4.68 | $10.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $75.86 | Facility | None | $8.13 | $9.55 | $75.86 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.24 Median $3.80 Typical High $10.47 | Professional | None | $3.24 | $3.80 | $10.47 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $5.25 | $5.25 | $5.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.58 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.07 |
Priority Health Setting Professional Modifier None Typical Low $3.72 Median $6.46 Typical High $10.23 | Professional | None | $3.72 | $6.46 | $10.23 |
United Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $16.22 | Professional | None | $8.91 | $11.22 | $16.22 |
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 LR · Lab round trip Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | LR · Lab round trip | $5.01 | $5.01 | $5.01 |
Where Michigan sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 22nd of 51
$10.00
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.