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 $19.50 Median $19.95 Typical High $38.90 | Facility | None | $19.50 | $19.95 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $20.89 | Professional | None | $19.05 | $19.50 | $20.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $19.95 Median $39.81 Typical High $74.13 | Facility | None | $19.95 | $39.81 | $74.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.89 Median $4.07 Typical High $4.57 | Professional | None | $3.89 | $4.07 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | None | $15.49 | $15.49 | $19.05 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.94 Median $19.95 Typical High $54.95 | Facility | None | $7.94 | $19.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.59 Median $19.05 Typical High $25.70 | Professional | None | $12.59 | $19.05 | $25.70 |
Priority Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | None | $15.49 | $15.49 | $19.05 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
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 $9.55 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.55 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.80 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.95 Typical High $2.95 | Professional | 55 · Aftercare only | $2.82 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.91 | $1.95 | $1.95 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $3.72 Median $3.89 Typical High $4.07 | Professional | JW · Drug discarded | $3.72 | $3.89 | $4.07 |
Where Michigan sits
The same service costs 2.7 times more in Wyoming than in Maryland. 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· 10th of 51
$19.05
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.