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 $23.99 Median $25.12 Typical High $70.79 | Facility | None | $23.99 | $25.12 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $34.67 | Professional | None | $22.91 | $23.99 | $34.67 |
BCBS Michigan Setting Facility Modifier None Typical Low $24.55 Median $47.86 Typical High $91.20 | Facility | None | $24.55 | $47.86 | $91.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $19.95 | Professional | None | $16.98 | $17.78 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $22.91 | Professional | None | $13.49 | $13.49 | $22.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $20.42 Median $53.70 Typical High $70.79 | Facility | None | $20.42 | $53.70 | $70.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $31.62 | Professional | None | $22.39 | $22.91 | $31.62 |
Priority Health Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $22.91 | Professional | None | $13.49 | $13.49 | $22.91 |
United Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $29.51 | Professional | None | $22.39 | $22.39 | $29.51 |
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 $11.48 Median $11.75 Typical High $19.50 | Professional | 52 · Reduced service | $11.48 | $11.75 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.79 Typical High $7.76 | Professional | 53 · Discontinued | $4.57 | $4.79 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.55 Typical High $5.89 | Professional | 55 · Aftercare only | $3.47 | $3.55 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.40 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.29 | $2.40 | $3.89 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $16.22 Median $16.98 Typical High $17.78 | Professional | JW · Drug discarded | $16.22 | $16.98 | $17.78 |
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $30.20 Median $67.61 Typical High $93.33 | Facility | JZ · No drug discarded | $30.20 | $67.61 | $93.33 |
Where Michigan sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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
$23.99
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.