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 $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $363.08 | Professional | None | $245.47 | $245.47 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,288.25 | Facility | None | $371.54 | $724.44 | $1,288.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $389.05 | Professional | None | $338.84 | $354.81 | $389.05 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $316.23 Median $338.84 Typical High $354.81 | Professional | JW · Drug discarded | $316.23 | $338.84 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $707.95 | Facility | None | $245.47 | $407.38 | $707.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $346.74 | Professional | None | $239.88 | $257.04 | $346.74 |
Priority Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
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 $120.23 Median $120.23 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $120.23 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $72.44 | Professional | 53 · Discontinued | $48.98 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $36.31 |
Where Michigan sits
The same service costs 8.7 times more in Alabama 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· 18th of 51
$331
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.