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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | None | $138.04 | $138.04 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
BCBS Michigan Setting Facility Modifier None Typical Low $131.83 Median $245.47 Typical High $512.86 | Facility | None | $131.83 | $245.47 | $512.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | None | $123.03 | $131.83 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $489.78 | Facility | None | $100.00 | $144.54 | $489.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $234.42 | Professional | None | $120.23 | $165.96 | $234.42 |
Priority Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
United Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $169.82 | Professional | None | $131.83 | $154.88 | $169.82 |
3 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 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $117.49 Median $123.03 Typical High $128.82 | Professional | JW · Drug discarded | $117.49 | $123.03 | $128.82 |
Where Michigan sits
The same service costs 4.1 times more in Colorado 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· 28th of 51
$141
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.