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 $0.38 Median $0.38 Typical High $0.47 | Facility | None | $0.38 | $0.38 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.38 Typical High $0.51 | Professional | None | $0.36 | $0.38 | $0.51 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.39 Median $0.76 Typical High $1.48 | Facility | None | $0.39 | $0.76 | $1.48 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.30 Median $0.32 Typical High $0.35 | Professional | None | $0.30 | $0.32 | $0.35 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $1.02 Typical High $1.02 | Professional | None | $0.37 | $1.02 | $1.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.38 Median $0.48 Typical High $2.69 | Facility | None | $0.38 | $0.48 | $2.69 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.24 Median $0.38 Typical High $0.56 | Professional | None | $0.24 | $0.38 | $0.56 |
Priority Health Setting Professional Modifier None Typical Low $0.37 Median $1.02 Typical High $1.02 | Professional | None | $0.37 | $1.02 | $1.02 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.31 | Professional | None | $0.23 | $0.23 | $0.31 |
5 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 52 · Reduced service Typical Low $0.19 Median $0.19 Typical High $0.24 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.08 Typical High $0.10 | Professional | 53 · Discontinued | $0.07 | $0.08 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.28 Median $0.30 Typical High $0.32 | Professional | JW · Drug discarded | $0.28 | $0.30 | $0.32 |
Where Michigan sits
The same service costs 7.8 times more in Texas than in Maryland. 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· 21st of 51
$0.38
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.