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 $239.88 Median $239.88 Typical High $302.00 | Facility | None | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | None | $239.88 | $239.88 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | None | $147.91 | $151.36 | $151.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $912.01 | Facility | None | $245.47 | $436.52 | $912.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $269.15 | Professional | None | $229.09 | $245.47 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $676.08 | Facility | None | $162.18 | $223.87 | $676.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $354.81 | Professional | None | $186.21 | $251.19 | $354.81 |
Priority Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
United Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $338.84 | Professional | None | $213.80 | $257.04 | $338.84 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | JW · Drug discarded | $218.78 | $229.09 | $239.88 |
Where Michigan sits
The same service costs 2.1 times more in Arizona 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· 24th of 51
$245
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.