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 $0.32 Median $0.91 Typical High $1.02 | Facility | None | $0.32 | $0.91 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $0.31 Median $0.32 Typical High $0.59 | Professional | None | $0.31 | $0.32 | $0.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $0.26 Median $0.51 Typical High $1.00 | Facility | None | $0.26 | $0.51 | $1.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $0.24 Median $0.25 Typical High $0.28 | Professional | None | $0.24 | $0.25 | $0.28 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.56 Median $0.83 Typical High $1.02 | Facility | None | $0.56 | $0.83 | $1.02 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.31 Median $0.33 Typical High $0.43 | Professional | None | $0.31 | $0.33 | $0.43 |
Priority Health Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.36 Typical High $0.46 | Professional | None | $0.32 | $0.36 | $0.46 |
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 $0.16 Typical High $0.50 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.20 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.15 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.10 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $0.23 Median $0.24 Typical High $0.24 | Professional | JW · Drug discarded | $0.23 | $0.24 | $0.24 |
Where Michigan sits
The same service costs 3.3 times more in Texas than in North Dakota. 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· 31st 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.