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 $43.65 Median $117.49 Typical High $131.83 | Facility | None | $43.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $57.54 | Professional | None | $42.66 | $43.65 | $57.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $151.36 | Facility | None | $43.65 | $53.70 | $151.36 |
BCBS Michigan Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $47.86 | Professional | None | $41.69 | $43.65 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | None | $41.69 | $41.69 | $42.66 |
Health Alliance Plan Setting Facility Modifier None Typical Low $45.71 Median $114.82 Typical High $131.83 | Facility | None | $45.71 | $114.82 | $131.83 |
Health Alliance Plan Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $57.54 | Professional | None | $41.69 | $43.65 | $57.54 |
Priority Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | None | $41.69 | $41.69 | $42.66 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | None | $40.74 | $40.74 | $54.95 |
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 $21.38 Median $21.88 Typical High $28.84 | Professional | 52 · Reduced service | $21.38 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $11.48 | Professional | 53 · Discontinued | $8.51 | $8.71 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $8.71 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $5.75 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | JW · Drug discarded | $38.90 | $40.74 | $42.66 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 20th of 51
$43.65
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.