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 $141.25 Typical High $158.49 | Facility | None | $66.07 | $141.25 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | None | $54.95 | $66.07 | $66.07 |
BCBS Michigan Setting Facility Modifier None Typical Low $54.95 Median $107.15 Typical High $204.17 | Facility | None | $54.95 | $107.15 | $204.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $57.54 | Professional | None | $50.12 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | None | $54.95 | $57.54 | $57.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $57.54 Median $141.25 Typical High $199.53 | Facility | None | $57.54 | $141.25 | $199.53 |
Health Alliance Plan Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $93.33 | Professional | None | $51.29 | $67.61 | $93.33 |
Priority Health Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | None | $54.95 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | None | $56.23 | $56.23 | $75.86 |
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 $27.54 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $13.49 | Professional | 53 · Discontinued | $10.96 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $8.13 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $6.61 | $6.61 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $46.77 Median $50.12 Typical High $52.48 | Professional | JW · Drug discarded | $46.77 | $50.12 | $52.48 |
Where Michigan sits
The same service costs 1.6 times more in Arizona than in California. 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· 5th of 51
$61.66
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.