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 $36.31 Median $100.00 Typical High $112.20 | Facility | None | $36.31 | $100.00 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $70.79 | Professional | None | $36.31 | $36.31 | $70.79 |
BCBS Michigan Setting Facility Modifier None Typical Low $34.67 Median $69.18 Typical High $134.90 | Facility | None | $34.67 | $69.18 | $134.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $22.39 | Professional | None | $19.05 | $20.42 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | None | $34.67 | $34.67 | $38.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.94 Median $100.00 Typical High $120.23 | Facility | None | $7.94 | $100.00 | $120.23 |
Health Alliance Plan Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $56.23 | Professional | None | $36.31 | $41.69 | $56.23 |
Priority Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Professional | None | $34.67 | $34.67 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
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 $18.20 Median $18.20 Typical High $35.48 | Professional | 52 · Reduced service | $18.20 | $18.20 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $14.13 | Professional | 53 · Discontinued | $7.24 | $7.24 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $10.72 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $7.08 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $18.20 Median $19.05 Typical High $19.95 | Professional | JW · Drug discarded | $18.20 | $19.05 | $19.95 |
Where Michigan sits
The same service costs 20.4 times more in Arizona 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· 36th of 51
$37.15
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.