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 $181.97 Median $181.97 Typical High $229.09 | Facility | None | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | None | $181.97 | $181.97 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $177.83 Median $331.13 Typical High $691.83 | Facility | None | $177.83 | $331.13 | $691.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $194.98 | Professional | None | $165.96 | $177.83 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | None | $138.04 | $138.04 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $549.54 | Facility | None | $158.49 | $199.53 | $549.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $275.42 | Professional | None | $144.54 | $186.21 | $275.42 |
Priority Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | None | $138.04 | $138.04 | $199.53 |
United Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $257.04 | Professional | None | $173.78 | $208.93 | $257.04 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $158.49 Median $165.96 Typical High $173.78 | Professional | JW · Drug discarded | $158.49 | $165.96 | $173.78 |
Where Michigan sits
The same service costs 562.3 times more in Montana 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· 33rd of 51
$186
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.