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 $7.41 Median $7.59 Typical High $22.39 | Facility | None | $7.41 | $7.59 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $10.00 | Professional | None | $7.08 | $7.41 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
BCBS Michigan Setting Facility Modifier None Typical Low $7.59 Median $14.79 Typical High $28.18 | Facility | None | $7.59 | $14.79 | $28.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.80 Median $3.98 Typical High $4.37 | Professional | None | $3.80 | $3.98 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | None | $7.08 | $7.24 | $7.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.41 Median $12.59 Typical High $24.55 | Facility | None | $7.41 | $12.59 | $24.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $6.92 Median $7.41 Typical High $12.59 | Professional | None | $6.92 | $7.41 | $12.59 |
Priority Health Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | None | $7.08 | $7.24 | $7.24 |
United Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $9.33 | Professional | None | $6.92 | $6.92 | $9.33 |
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 $3.55 Median $3.63 Typical High $7.94 | Professional | 52 · Reduced service | $3.55 | $3.63 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.48 Typical High $3.24 | Professional | 53 · Discontinued | $1.45 | $1.48 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.10 Typical High $2.40 | Professional | 55 · Aftercare only | $1.07 | $1.10 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $1.58 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $3.55 Median $3.80 Typical High $3.98 | Professional | JW · Drug discarded | $3.55 | $3.80 | $3.98 |
Where Michigan sits
The same service costs 2.0 times more in Alaska than in Maryland. 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· 28th of 51
$7.41
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.