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 $40.74 Median $114.82 Typical High $128.82 | Facility | None | $40.74 | $114.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $128.82 | Professional | None | $39.81 | $40.74 | $128.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $38.02 Median $45.71 Typical High $131.83 | Facility | None | $38.02 | $45.71 | $131.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $41.69 | Professional | None | $35.48 | $38.02 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | None | $38.90 | $41.69 | $41.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $44.67 Median $104.71 Typical High $128.82 | Facility | None | $44.67 | $104.71 | $128.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $53.70 | Professional | None | $39.81 | $41.69 | $53.70 |
Priority Health Setting Professional Modifier None Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | None | $38.90 | $41.69 | $41.69 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
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 $19.95 Median $20.42 Typical High $64.57 | Professional | 52 · Reduced service | $19.95 | $20.42 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $25.70 | Professional | 53 · Discontinued | $7.94 | $8.13 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $19.05 | Professional | 55 · Aftercare only | $6.03 | $6.17 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.07 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.98 | $4.07 | $12.88 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $33.88 Median $35.48 Typical High $37.15 | Professional | JW · Drug discarded | $33.88 | $35.48 | $37.15 |
Where Michigan sits
The same service costs 1.6 times more in Arizona 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· 19th of 51
$40.74
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.