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 $0.33 Median $0.81 Typical High $0.89 | Facility | None | $0.33 | $0.81 | $0.89 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.33 Typical High $0.47 | Professional | None | $0.32 | $0.33 | $0.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.27 Median $0.52 Typical High $1.05 | Facility | None | $0.27 | $0.52 | $1.05 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.25 Median $0.26 Typical High $0.28 | Professional | None | $0.25 | $0.26 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.32 Median $0.66 Typical High $0.66 | Professional | None | $0.32 | $0.66 | $0.66 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.45 Median $0.85 Typical High $0.93 | Facility | None | $0.45 | $0.85 | $0.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.28 Median $0.32 Typical High $0.43 | Professional | None | $0.28 | $0.32 | $0.43 |
Priority Health Setting Professional Modifier None Typical Low $0.32 Median $0.66 Typical High $0.66 | Professional | None | $0.32 | $0.66 | $0.66 |
United Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.31 Typical High $0.41 | Professional | None | $0.28 | $0.31 | $0.41 |
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 $0.16 Median $0.17 Typical High $0.45 | Professional | 52 · Reduced service | $0.16 | $0.17 | $0.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.07 Typical High $0.18 | Professional | 53 · Discontinued | $0.06 | $0.07 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.14 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.09 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.24 Median $0.24 Typical High $0.33 | Professional | JW · Drug discarded | $0.24 | $0.24 | $0.33 |
Where Michigan sits
The same service costs 2.8 times more in Texas than in Rhode Island. 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· 17th of 51
$0.33
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.