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 $177.83 Median $181.97 Typical High $295.12 | Facility | None | $177.83 | $181.97 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $177.83 Typical High $295.12 | Professional | None | $173.78 | $177.83 | $295.12 |
BCBS Setting Facility Modifier None Typical Low $181.97 Median $363.08 Typical High $707.95 | Facility | None | $181.97 | $363.08 | $707.95 |
BCBS Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | None | $95.50 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $173.78 | Professional | None | $79.43 | $79.43 | $173.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $181.97 Typical High $501.19 | Facility | None | $85.11 | $181.97 | $501.19 |
Health Alliance Plan Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $234.42 | Professional | None | $83.18 | $173.78 | $234.42 |
Priority Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $173.78 | Professional | None | $79.43 | $79.43 | $173.78 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $123.03 | Professional | None | $91.20 | $91.20 | $123.03 |
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 $87.10 Median $89.13 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $89.13 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $35.48 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $35.48 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $29.51 |
BCBS Setting Professional Modifier JW · Drug discarded Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | JW · Drug discarded | $89.13 | $93.33 | $97.72 |
Where Michigan sits
The same service costs 3.2 times more in Wyoming 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· 25th of 51
$174
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.