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 $0.02 Median $0.02 Typical High $0.06 | Facility | None | $0.02 | $0.02 | $0.06 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.07 Median $0.15 Typical High $0.28 | Facility | None | $0.07 | $0.15 | $0.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
CareSource Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.39 | Professional | None | $0.28 | $0.28 | $0.39 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.38 | Professional | None | $0.02 | $0.02 | $0.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.02 Median $0.08 Typical High $3.47 | Facility | None | $0.02 | $0.08 | $3.47 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | None | $0.02 | $0.03 | $0.03 |
Priority Health Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.38 | Professional | None | $0.02 | $0.02 | $0.38 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
4 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 $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 $0.60 Median $0.60 Typical High $0.60 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.60 |
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 |
Where Michigan sits
The same service costs 26.3 times more in Montana than in Virginia. 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· 24th of 51
$0.02
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.