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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | None | $144.54 | $144.54 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $141.25 Median $263.03 Typical High $549.54 | Facility | None | $141.25 | $263.03 | $549.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | None | $134.90 | $141.25 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Health Alliance Plan Setting Facility Modifier None Typical Low $141.25 Median $158.49 Typical High $524.81 | Facility | None | $141.25 | $158.49 | $524.81 |
Health Alliance Plan Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $245.47 | Professional | None | $134.90 | $177.83 | $245.47 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
United Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $204.17 | Professional | None | $138.04 | $165.96 | $204.17 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | JW · Drug discarded | $125.89 | $131.83 | $141.25 |
Where Michigan sits
The same service costs 1.9 times more in Arizona than in New Mexico. 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· 26th of 51
$155
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.