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 $79.43 Median $134.90 Typical High $151.36 | Facility | None | $79.43 | $134.90 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $151.36 | Professional | None | $77.62 | $79.43 | $151.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $83.18 Median $162.18 Typical High $309.03 | Facility | None | $83.18 | $162.18 | $309.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $33.11 | Professional | None | $28.84 | $30.20 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | None | $51.29 | $51.29 | $77.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $229.09 | Facility | None | $58.88 | $134.90 | $229.09 |
Health Alliance Plan Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $109.65 | Professional | None | $47.86 | $77.62 | $109.65 |
Priority Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | None | $51.29 | $51.29 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | None | $46.77 | $46.77 | $63.10 |
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 $38.90 Median $39.81 Typical High $75.86 | Professional | 52 · Reduced service | $38.90 | $39.81 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $30.20 | Professional | 53 · Discontinued | $15.49 | $15.85 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.02 Typical High $22.39 | Professional | 55 · Aftercare only | $11.75 | $12.02 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $15.14 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $26.92 Median $28.18 Typical High $29.51 | Professional | JW · Drug discarded | $26.92 | $28.18 | $29.51 |
Where Michigan sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 14th of 51
$77.62
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.