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 $489.78 Median $1,348.96 Typical High $1,513.56 | Facility | None | $489.78 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $794.33 | Professional | None | $489.78 | $489.78 | $794.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $1,819.70 | Facility | None | $512.86 | $512.86 | $1,819.70 |
BCBS Michigan Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $562.34 | Professional | None | $489.78 | $512.86 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $1,905.46 | Facility | None | $549.54 | $1,348.96 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $891.25 | Professional | None | $489.78 | $645.65 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $676.08 | Professional | None | $512.86 | $512.86 | $676.08 |
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 $245.47 Median $245.47 Typical High $389.05 | Professional | 52 · Reduced service | $245.47 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $158.49 | Professional | 53 · Discontinued | $97.72 | $97.72 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $117.49 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $79.43 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $79.43 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $457.09 Median $489.78 Typical High $512.86 | Professional | JW · Drug discarded | $457.09 | $489.78 | $512.86 |
Where Michigan sits
The same service costs 1.7 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· 35th of 51
$525
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.