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 $44.67 Median $154.88 Typical High $173.78 | Facility | None | $44.67 | $154.88 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $173.78 | Professional | None | $43.65 | $44.67 | $173.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $46.77 Median $91.20 Typical High $177.83 | Facility | None | $46.77 | $91.20 | $177.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.79 Median $5.01 Typical High $5.50 | Professional | None | $4.79 | $5.01 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | None | $43.65 | $52.48 | $52.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $39.81 Median $117.49 Typical High $173.78 | Facility | None | $39.81 | $117.49 | $173.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $61.66 | Professional | None | $43.65 | $52.48 | $61.66 |
Priority Health Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | None | $43.65 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
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 $21.88 Median $22.39 Typical High $87.10 | Professional | 52 · Reduced service | $21.88 | $22.39 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $34.67 | Professional | 53 · Discontinued | $8.71 | $9.12 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.76 Typical High $26.30 | Professional | 55 · Aftercare only | $6.61 | $6.76 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $17.38 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $17.38 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $4.47 Median $4.68 Typical High $4.90 | Professional | JW · Drug discarded | $4.47 | $4.68 | $4.90 |
Where Michigan sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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
$52.48
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.