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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | None | $51.29 | $51.29 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $47.86 Median $89.13 Typical High $186.21 | Facility | None | $47.86 | $89.13 | $186.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $45.71 Median $47.86 Typical High $52.48 | Professional | None | $45.71 | $47.86 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $35.48 Median $53.70 Typical High $147.91 | Facility | None | $35.48 | $53.70 | $147.91 |
Health Alliance Plan Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $75.86 | Professional | None | $45.71 | $51.29 | $75.86 |
Priority Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $53.70 | Professional | None | $38.02 | $38.02 | $53.70 |
United Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $69.18 | Professional | None | $46.77 | $54.95 | $69.18 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $42.66 Median $44.67 Typical High $46.77 | Professional | JW · Drug discarded | $42.66 | $44.67 | $46.77 |
Where Michigan sits
The same service costs 1.5 times more in Colorado than in Alaska. 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
$51.29
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.