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 $269.15 Median $269.15 Typical High $281.84 | Facility | None | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $407.38 | Professional | None | $269.15 | $269.15 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | None | $229.09 | $269.15 | $269.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $954.99 | Facility | None | $251.19 | $501.19 | $954.99 |
BCBS Michigan Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $263.03 | Professional | None | $229.09 | $239.88 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Health Alliance Plan Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $776.25 | Facility | None | $281.84 | $549.54 | $776.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $416.87 | Professional | None | $251.19 | $281.84 | $416.87 |
Priority Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $257.04 | Facility | None | $245.47 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | None | $239.88 | $288.40 | $346.74 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | JW · Drug discarded | $213.80 | $223.87 | $239.88 |
Where Michigan sits
The same service costs 2.3 times more in Arizona than in Alabama. 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· 20th of 51
$282
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.