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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | None | $66.07 | $66.07 | $74.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $64.57 Median $120.23 Typical High $251.19 | Facility | None | $64.57 | $120.23 | $251.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $70.79 | Professional | None | $61.66 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $218.78 | Facility | None | $77.62 | $109.65 | $218.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $100.00 | Professional | None | $66.07 | $74.13 | $100.00 |
Priority Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $93.33 | Professional | None | $74.13 | $89.13 | $93.33 |
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 $33.11 Median $33.11 Typical High $37.15 | Professional | 52 · Reduced service | $33.11 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | 53 · Discontinued | $13.18 | $13.18 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.41 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $57.54 Median $60.26 Typical High $64.57 | Professional | JW · Drug discarded | $57.54 | $60.26 | $64.57 |
Where Michigan sits
The same service costs 2.8 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· 37th of 51
$74.13
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.