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 $19.05 Median $52.48 Typical High $58.88 | Facility | None | $19.05 | $52.48 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $20.89 | Professional | None | $18.62 | $19.05 | $20.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $19.05 Median $22.91 Typical High $66.07 | Facility | None | $19.05 | $22.91 | $66.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $14.45 | Professional | None | $12.30 | $13.18 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $21.88 Median $50.12 Typical High $58.88 | Facility | None | $21.88 | $50.12 | $58.88 |
Health Alliance Plan Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $25.12 | Professional | None | $18.62 | $19.05 | $25.12 |
Priority Health Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $24.55 | Professional | None | $18.20 | $18.20 | $24.55 |
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 $9.33 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.91 | $1.91 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $11.75 Median $12.30 Typical High $12.88 | Professional | JW · Drug discarded | $11.75 | $12.30 | $12.88 |
Where Michigan sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 16th of 51
$19.05
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.