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 $12.30 Median $35.48 Typical High $39.81 | Facility | None | $12.30 | $35.48 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | None | $12.02 | $12.30 | $12.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $12.88 Median $25.12 Typical High $47.86 | Facility | None | $12.88 | $25.12 | $47.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $7.76 | Professional | None | $6.76 | $7.08 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $45.71 | Professional | None | $12.02 | $45.71 | $45.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $12.88 Median $32.36 Typical High $39.81 | Facility | None | $12.88 | $32.36 | $39.81 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $16.22 | Professional | None | $12.02 | $12.88 | $16.22 |
Priority Health Setting Professional Modifier None Typical Low $12.02 Median $45.71 Typical High $45.71 | Professional | None | $12.02 | $45.71 | $45.71 |
United Setting Professional Modifier None Typical Low $12.30 Median $67.61 Typical High $72.44 | Professional | None | $12.30 | $67.61 | $72.44 |
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 $6.03 Median $6.17 Typical High $19.95 | Professional | 52 · Reduced service | $6.03 | $6.17 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.45 Typical High $7.94 | Professional | 53 · Discontinued | $2.40 | $2.45 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.86 Typical High $6.03 | Professional | 55 · Aftercare only | $1.82 | $1.86 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.23 Typical High $3.98 | Professional | 56 · Pre-op care only | $1.20 | $1.23 | $3.98 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $6.31 Median $6.61 Typical High $6.92 | Professional | JW · Drug discarded | $6.31 | $6.61 | $6.92 |
Where Michigan sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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
$13.49
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.