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 $11.48 Median $11.75 Typical High $36.31 | Facility | None | $11.48 | $11.75 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $15.14 | Professional | None | $11.22 | $11.48 | $15.14 |
BCBS Michigan Setting Facility Modifier None Typical Low $11.75 Median $23.44 Typical High $44.67 | Facility | None | $11.75 | $23.44 | $44.67 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.25 Median $5.50 Typical High $6.03 | Professional | None | $5.25 | $5.50 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.94 Median $15.85 Typical High $36.31 | Facility | None | $7.94 | $15.85 | $36.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $15.14 | Professional | None | $11.22 | $11.75 | $15.14 |
Priority Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | None | $11.22 | $11.22 | $15.14 |
7 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 $5.62 Median $5.75 Typical High $12.59 | Professional | 52 · Reduced service | $5.62 | $5.75 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.29 Typical High $5.01 | Professional | 53 · Discontinued | $2.24 | $2.29 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.74 Typical High $3.72 | Professional | 55 · Aftercare only | $1.66 | $1.74 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $2.51 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | JZ · No drug discarded | $11.22 | $11.22 | $11.22 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $4.90 Median $5.25 Typical High $5.50 | Professional | JW · Drug discarded | $4.90 | $5.25 | $5.50 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $5.25 Median $18.62 Typical High $23.99 | Facility | JZ · No drug discarded | $5.25 | $18.62 | $23.99 |
Where Michigan sits
The same service costs 3.3 times more in Alaska than in Texas. 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· 19th of 51
$11.48
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.