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 $56.23 Median $158.49 Typical High $177.83 | Facility | None | $56.23 | $158.49 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $177.83 | Professional | None | $54.95 | $56.23 | $177.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $58.88 Median $114.82 Typical High $218.78 | Facility | None | $58.88 | $114.82 | $218.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $47.86 | Professional | None | $40.74 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $64.57 Median $147.91 Typical High $177.83 | Facility | None | $64.57 | $147.91 | $177.83 |
Health Alliance Plan Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $74.13 | Professional | None | $54.95 | $56.23 | $74.13 |
Priority Health Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $60.26 | Professional | None | $54.95 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
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 $27.54 Median $28.18 Typical High $89.13 | Professional | 52 · Reduced service | $27.54 | $28.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $35.48 | Professional | 53 · Discontinued | $10.96 | $11.22 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $26.30 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $17.78 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | JW · Drug discarded | $38.90 | $40.74 | $42.66 |
Where Michigan sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 34th of 51
$56.23
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.