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 $218.78 Median $588.84 Typical High $660.69 | Facility | None | $218.78 | $588.84 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $575.44 | Professional | None | $208.93 | $218.78 | $575.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $758.58 | Facility | None | $213.80 | $263.03 | $758.58 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $234.42 | Professional | None | $204.17 | $213.80 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | None | $177.83 | $177.83 | $208.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $223.87 Median $575.44 Typical High $660.69 | Facility | None | $223.87 | $575.44 | $660.69 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $288.40 | Professional | None | $208.93 | $213.80 | $288.40 |
Priority Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | None | $177.83 | $177.83 | $208.93 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | None | $208.93 | $208.93 | $275.42 |
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 $104.71 Median $109.65 Typical High $288.40 | Professional | 52 · Reduced service | $104.71 | $109.65 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $43.65 Typical High $117.49 | Professional | 53 · Discontinued | $42.66 | $43.65 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $87.10 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $57.54 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $57.54 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | JW · Drug discarded | $190.55 | $204.17 | $213.80 |
Where Michigan sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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· 20th of 51
$214
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.