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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | None | $75.86 | $75.86 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | None | $64.57 | $64.57 | $75.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $288.40 | Facility | None | $75.86 | $151.36 | $288.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $69.18 Median $72.44 Typical High $79.43 | Professional | None | $69.18 | $72.44 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $75.86 Median $104.71 Typical High $218.78 | Facility | None | $75.86 | $104.71 | $218.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $128.82 | Professional | None | $70.79 | $79.43 | $128.82 |
Priority Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
United Setting Facility Modifier None Typical Low $75.86 Median $81.28 Typical High $81.28 | Facility | None | $75.86 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $107.15 | Professional | None | $72.44 | $87.10 | $107.15 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | JW · Drug discarded | $64.57 | $67.61 | $70.79 |
Where Michigan sits
The same service costs 2.8 times more in Alaska 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· 36th of 51
$77.62
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.