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 $38.02 Median $107.15 Typical High $120.23 | Facility | None | $38.02 | $107.15 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | None | $38.02 | $38.02 | $40.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $43.65 Median $85.11 Typical High $162.18 | Facility | None | $43.65 | $85.11 | $162.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $44.67 | Professional | None | $38.90 | $40.74 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $42.66 Median $107.15 Typical High $147.91 | Facility | None | $42.66 | $107.15 | $147.91 |
Health Alliance Plan Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $69.18 | Professional | None | $38.02 | $51.29 | $69.18 |
Priority Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
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 $19.05 Median $19.05 Typical High $20.42 | Professional | 52 · Reduced service | $19.05 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.13 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.07 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $36.31 Median $38.02 Typical High $39.81 | Professional | JW · Drug discarded | $36.31 | $38.02 | $39.81 |
Where Michigan sits
The same service costs 1.8 times more in Alaska than in Nebraska. 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· 7th of 51
$42.66
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.