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 $112.20 Median $302.00 Typical High $338.84 | Facility | None | $112.20 | $302.00 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $338.84 | Professional | None | $109.65 | $112.20 | $338.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $117.49 Median $229.09 Typical High $436.52 | Facility | None | $117.49 | $229.09 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | None | $107.15 | $112.20 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | None | $95.50 | $95.50 | $109.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $117.49 Median $295.12 Typical High $338.84 | Facility | None | $117.49 | $295.12 | $338.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $147.91 | Professional | None | $107.15 | $109.65 | $147.91 |
Priority Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | None | $95.50 | $95.50 | $109.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None | $104.71 | $104.71 | $141.25 |
6 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 $54.95 Median $56.23 Typical High $169.82 | Professional | 52 · Reduced service | $54.95 | $56.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $67.61 | Professional | 53 · Discontinued | $21.88 | $22.39 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $85.11 Typical High $251.19 | Professional | 54 · Surgery only | $83.18 | $85.11 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $50.12 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $33.88 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | JW · Drug discarded | $100.00 | $104.71 | $109.65 |
Where Michigan sits
The same service costs 5.0 times more in Alabama 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· 18th of 51
$112
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.