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 $134.90 Median $371.54 Typical High $416.87 | Facility | None | $134.90 | $371.54 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $223.87 | Professional | None | $128.82 | $134.90 | $223.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $457.09 | Facility | None | $131.83 | $162.18 | $457.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | None | $125.89 | $131.83 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $141.25 Median $354.81 Typical High $416.87 | Facility | None | $141.25 | $354.81 | $416.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $177.83 | Professional | None | $128.82 | $134.90 | $177.83 |
Priority Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
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 $64.57 Median $67.61 Typical High $112.20 | Professional | 52 · Reduced service | $64.57 | $67.61 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $44.67 | Professional | 53 · Discontinued | $25.70 | $26.92 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $33.11 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $22.39 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $117.49 Median $123.03 Typical High $131.83 | Professional | JW · Drug discarded | $117.49 | $123.03 | $131.83 |
Where Michigan sits
The same service costs 1.6 times more in Texas than in North Carolina. 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
$135
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.