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 $141.25 Typical High $354.81 | Facility | None | $112.20 | $141.25 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | None | $112.20 | $112.20 | $177.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $467.74 | Facility | None | $123.03 | $245.47 | $467.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $131.83 | Professional | None | $112.20 | $120.23 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | None | $117.49 | $117.49 | $120.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $128.82 Median $316.23 Typical High $436.52 | Facility | None | $128.82 | $316.23 | $436.52 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | None | $112.20 | $151.36 | $204.17 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | None | $117.49 | $117.49 | $120.23 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
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 $56.23 Median $56.23 Typical High $60.26 | Professional | 52 · Reduced service | $56.23 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $12.02 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $107.15 Median $112.20 Typical High $117.49 | Professional | JW · Drug discarded | $107.15 | $112.20 | $117.49 |
Where Michigan sits
The same service costs 2.3 times more in Texas than in Hawaii. 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· 37th of 51
$120
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.