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 $60.26 Median $61.66 Typical High $147.91 | Facility | None | $60.26 | $61.66 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $173.78 | Professional | None | $60.26 | $60.26 | $173.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $10.47 Median $20.42 Typical High $39.81 | Facility | None | $10.47 | $20.42 | $39.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.00 Median $2.09 Typical High $2.29 | Professional | None | $2.00 | $2.09 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | None | $51.29 | $56.23 | $56.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $17.78 Median $61.66 Typical High $154.88 | Facility | None | $17.78 | $61.66 | $154.88 |
Health Alliance Plan Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $74.13 | Professional | None | $46.77 | $56.23 | $74.13 |
Priority Health Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | None | $51.29 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | None | $63.10 | $63.10 | $85.11 |
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 $30.20 Median $30.20 Typical High $74.13 | Professional | 52 · Reduced service | $30.20 | $30.20 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $29.51 | Professional | 53 · Discontinued | $12.02 | $12.02 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $21.88 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $14.79 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1.86 Median $1.95 Typical High $2.04 | Professional | JW · Drug discarded | $1.86 | $1.95 | $2.04 |
Where Michigan sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 44th of 51
$56.23
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.