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 $42.66 Median $141.25 Typical High $158.49 | Facility | None | $42.66 | $141.25 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $42.66 | Professional | None | $41.69 | $42.66 | $42.66 |
BCBS Michigan Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $169.82 | Facility | None | $43.65 | $87.10 | $169.82 |
BCBS Michigan Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $21.88 | Professional | None | $18.62 | $19.50 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $199.53 Typical High $199.53 | Professional | None | $41.69 | $199.53 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $51.29 Median $123.03 Typical High $302.00 | Facility | None | $51.29 | $123.03 | $302.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $67.61 | Professional | None | $41.69 | $50.12 | $67.61 |
Priority Health Setting Professional Modifier None Typical Low $41.69 Median $199.53 Typical High $199.53 | Professional | None | $41.69 | $199.53 | $199.53 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $72.44 | Professional | None | $50.12 | $54.95 | $72.44 |
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 $20.89 Median $21.38 Typical High $83.18 | Professional | 52 · Reduced service | $20.89 | $21.38 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.51 Typical High $33.11 | Professional | 53 · Discontinued | $8.32 | $8.51 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $25.12 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $16.60 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $16.60 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $17.78 Median $18.62 Typical High $19.50 | Professional | JW · Drug discarded | $17.78 | $18.62 | $19.50 |
Where Michigan sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 25th of 51
$51.29
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.