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 $28.84 Median $36.31 Typical High $77.62 | Facility | None | $28.84 | $36.31 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $67.61 | Professional | None | $28.18 | $28.84 | $67.61 |
BCBS Michigan Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $112.20 | Facility | None | $30.20 | $58.88 | $112.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $20.89 | Professional | None | $17.78 | $19.05 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $28.18 | Professional | None | $17.78 | $17.78 | $28.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $25.12 Median $63.10 Typical High $83.18 | Facility | None | $25.12 | $63.10 | $83.18 |
Health Alliance Plan Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $38.02 | Professional | None | $25.12 | $28.18 | $38.02 |
Priority Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $28.18 | Professional | None | $17.78 | $17.78 | $28.18 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $32.36 | Professional | None | $24.55 | $24.55 | $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 $14.13 Median $14.45 Typical High $33.88 | Professional | 52 · Reduced service | $14.13 | $14.45 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.75 Typical High $13.49 | Professional | 53 · Discontinued | $5.62 | $5.75 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $10.00 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $6.76 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $6.76 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $16.98 Median $17.78 Typical High $18.62 | Professional | JW · Drug discarded | $16.98 | $17.78 | $18.62 |
Where Michigan sits
The same service costs 2.2 times more in Alaska than in Oklahoma. 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· 17th of 51
$28.18
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.