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 $120.23 Median $123.03 Typical High $467.74 | Facility | None | $120.23 | $123.03 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $363.08 | Professional | None | $117.49 | $120.23 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $478.63 | Facility | None | $125.89 | $245.47 | $478.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | None | $41.69 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | None | $117.49 | $208.93 | $208.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $123.03 Median $338.84 Typical High $616.60 | Facility | None | $123.03 | $338.84 | $616.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $190.55 | Professional | None | $117.49 | $134.90 | $190.55 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $208.93 | Professional | None | $117.49 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | None | $147.91 | $147.91 | $194.98 |
6 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 $58.88 Median $60.26 Typical High $234.42 | Professional | 52 · Reduced service | $58.88 | $60.26 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $93.33 | Professional | 53 · Discontinued | $23.44 | $23.99 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $70.79 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $46.77 |
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 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $97.72 Median $363.08 Typical High $630.96 | Facility | JZ · No drug discarded | $97.72 | $363.08 | $630.96 |
Where Michigan sits
The same service costs 2.0 times more in Kansas 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· 21st of 51
$151
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.