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 $331.13 Median $331.13 Typical High $416.87 | Facility | None | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $524.81 | Professional | None | $331.13 | $331.13 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $1,621.81 | Facility | None | $457.09 | $831.76 | $1,621.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $501.19 | Professional | None | $426.58 | $457.09 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $501.19 | Professional | None | $380.19 | $380.19 | $501.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $331.13 Median $794.33 Typical High $1,202.26 | Facility | None | $331.13 | $794.33 | $1,202.26 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $446.68 | Professional | None | $316.23 | $338.84 | $446.68 |
Priority Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $501.19 | Professional | None | $380.19 | $380.19 | $501.19 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $537.03 | Professional | None | $331.13 | $380.19 | $537.03 |
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 $165.96 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.88 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | JW · Drug discarded | $407.38 | $426.58 | $446.68 |
Where Michigan sits
The same service costs 3.5 times more in Minnesota 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· 19th of 51
$457
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.