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 $169.82 Median $467.74 Typical High $524.81 | Facility | None | $169.82 | $467.74 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $229.09 | Professional | None | $165.96 | $169.82 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $588.84 | Facility | None | $169.82 | $208.93 | $588.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $186.21 | Professional | None | $158.49 | $169.82 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | None | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $190.55 Median $446.68 Typical High $524.81 | Facility | None | $190.55 | $446.68 | $524.81 |
Health Alliance Plan Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $223.87 | Professional | None | $165.96 | $173.78 | $223.87 |
Priority Health Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | None | $165.96 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
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 $83.18 Median $85.11 Typical High $181.97 | Professional | 52 · Reduced service | $83.18 | $85.11 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $72.44 | Professional | 53 · Discontinued | $33.11 | $33.88 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $54.95 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $36.31 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $151.36 Median $158.49 Typical High $165.96 | Professional | JW · Drug discarded | $151.36 | $158.49 | $165.96 |
Where Michigan sits
The same service costs 1.6 times more in Arizona 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· 22nd of 51
$170
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.