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 $8.71 Median $8.71 Typical High $30.20 | Facility | None | $8.71 | $8.71 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | None | $8.51 | $8.71 | $8.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $9.12 Median $17.78 Typical High $34.67 | Facility | None | $9.12 | $17.78 | $34.67 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.27 Median $4.57 Typical High $5.01 | Professional | None | $4.27 | $4.57 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $60.26 Typical High $60.26 | Professional | None | $8.51 | $60.26 | $60.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $9.12 Median $45.71 Typical High $69.18 | Facility | None | $9.12 | $45.71 | $69.18 |
Health Alliance Plan Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $20.42 | Professional | None | $8.51 | $9.55 | $20.42 |
Priority Health Setting Professional Modifier None Typical Low $8.51 Median $60.26 Typical High $60.26 | Professional | None | $8.51 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $12.59 | Professional | None | $9.33 | $9.33 | $12.59 |
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 $4.27 Median $4.37 Typical High $15.14 | Professional | 52 · Reduced service | $4.27 | $4.37 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.78 Typical High $6.03 | Professional | 53 · Discontinued | $1.70 | $1.78 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.32 Typical High $4.47 | Professional | 55 · Aftercare only | $1.29 | $1.32 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.87 Typical High $3.02 | Professional | 56 · Pre-op care only | $0.85 | $0.87 | $3.02 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $4.07 Median $4.27 Typical High $4.47 | Professional | JW · Drug discarded | $4.07 | $4.27 | $4.47 |
Where Michigan sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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· 17th of 51
$10.72
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.