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 $64.57 Median $177.83 Typical High $199.53 | Facility | None | $64.57 | $177.83 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $93.33 | Professional | None | $63.10 | $64.57 | $93.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $245.47 | Facility | None | $64.57 | $128.82 | $245.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $70.79 | Professional | None | $60.26 | $63.10 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | None | $44.67 | $44.67 | $63.10 |
Health Alliance Plan Setting Facility Modifier None Typical Low $67.61 Median $169.82 Typical High $199.53 | Facility | None | $67.61 | $169.82 | $199.53 |
Health Alliance Plan Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | None | $63.10 | $63.10 | $85.11 |
Priority Health Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $63.10 | Professional | None | $44.67 | $44.67 | $63.10 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $89.13 | Professional | None | $61.66 | $69.18 | $89.13 |
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 $30.90 Median $32.36 Typical High $61.66 | Professional | 52 · Reduced service | $30.90 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $24.55 | Professional | 53 · Discontinued | $12.59 | $12.88 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $18.62 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.46 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.31 | $6.46 | $12.30 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $56.23 Median $60.26 Typical High $63.10 | Professional | JW · Drug discarded | $56.23 | $60.26 | $63.10 |
Where Michigan sits
The same service costs 9.3 times more in Alabama than in Oklahoma. 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· 27th of 51
$64.57
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.