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 $87.10 Median $234.42 Typical High $263.03 | Facility | None | $87.10 | $234.42 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $234.42 | Professional | None | $83.18 | $87.10 | $234.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $85.11 Median $104.71 Typical High $302.00 | Facility | None | $85.11 | $104.71 | $302.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $93.33 | Professional | None | $81.28 | $85.11 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $93.33 Median $229.09 Typical High $263.03 | Facility | None | $93.33 | $229.09 | $263.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $114.82 | Professional | None | $83.18 | $87.10 | $114.82 |
Priority Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
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 $41.69 Median $43.65 Typical High $117.49 | Professional | 52 · Reduced service | $41.69 | $43.65 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $46.77 | Professional | 53 · Discontinued | $16.98 | $17.38 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $35.48 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $23.44 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $75.86 Median $81.28 Typical High $85.11 | Professional | JW · Drug discarded | $75.86 | $81.28 | $85.11 |
Where Michigan sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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· 18th of 51
$85.11
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.