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 $32.36 Median $32.36 Typical High $40.74 | Facility | None | $32.36 | $32.36 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $42.66 | Professional | None | $32.36 | $32.36 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $30.90 Median $57.54 Typical High $120.23 | Facility | None | $30.90 | $57.54 | $120.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $33.88 | Professional | None | $28.84 | $30.90 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | None | $28.18 | $28.18 | $34.67 |
Health Alliance Plan Setting Facility Modifier None Typical Low $29.51 Median $39.81 Typical High $95.50 | Facility | None | $29.51 | $39.81 | $95.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $57.54 | Professional | None | $30.90 | $35.48 | $57.54 |
Priority Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | None | $28.18 | $28.18 | $34.67 |
United Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $44.67 | Professional | None | $30.90 | $37.15 | $44.67 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $27.54 Median $28.84 Typical High $30.20 | Professional | JW · Drug discarded | $27.54 | $28.84 | $30.20 |
Where Michigan sits
The same service costs 5.4 times more in Arizona than in Rhode Island. 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· 35th of 51
$33.88
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.