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 $39.81 Median $109.65 Typical High $123.03 | Facility | None | $39.81 | $109.65 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | None | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $23.44 | Professional | 52 · Reduced service | $19.50 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $245.47 | Facility | None | $72.44 | $141.25 | $245.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | None | $21.88 | $26.92 | $26.92 |
Health Alliance Plan Setting Facility Modifier None Typical Low $39.81 Median $74.13 Typical High $123.03 | Facility | None | $39.81 | $74.13 | $123.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $19.95 Median $28.18 Typical High $39.81 | Professional | None | $19.95 | $28.18 | $39.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.50 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $5.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Priority Health Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | None | $25.70 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $75.86 | Professional | None | $28.84 | $70.79 | $75.86 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | JW · Drug discarded | $61.66 | $64.57 | $64.57 |
Where Michigan sits
The same service costs 3.1 times more in Wisconsin than in New York. 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
$39.81
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.