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 $25.70 Median $69.18 Typical High $77.62 | Facility | None | $25.70 | $69.18 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $37.15 | Professional | None | $24.55 | $25.70 | $37.15 |
BCBS Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $89.13 | Facility | None | $25.12 | $33.88 | $89.13 |
BCBS Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $27.54 | Professional | None | $23.99 | $25.12 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $27.54 Median $66.07 Typical High $77.62 | Facility | None | $27.54 | $66.07 | $77.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $33.88 | Professional | None | $24.55 | $25.12 | $33.88 |
Priority Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $32.36 | Professional | None | $23.99 | $23.99 | $32.36 |
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 $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
BCBS Setting Professional Modifier JW · Drug discarded Typical Low $22.39 Median $23.44 Typical High $24.55 | Professional | JW · Drug discarded | $22.39 | $23.44 | $24.55 |
Where Michigan sits
The same service costs 234.4 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· 23rd of 51
$25.12
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.