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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $114.82 | Professional | None | $87.10 | $87.10 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $85.11 Median $162.18 Typical High $338.84 | Facility | None | $85.11 | $162.18 | $338.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $93.33 | Professional | None | $81.28 | $85.11 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None | $77.62 | $77.62 | $95.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $263.03 | Facility | None | $87.10 | $100.00 | $263.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $123.03 | Professional | None | $87.10 | $91.20 | $123.03 |
Priority Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None | $77.62 | $77.62 | $95.50 |
United Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $144.54 | Professional | None | $85.11 | $102.33 | $144.54 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | JW · Drug discarded | $75.86 | $79.43 | $85.11 |
Where Michigan sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 39th of 51
$91.20
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.