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 $66.07 Typical High $181.97 | Facility | None | $64.57 | $66.07 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
BCBS Michigan Setting Facility Modifier None Typical Low $67.61 Median $131.83 Typical High $251.19 | Facility | None | $67.61 | $131.83 | $251.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | None | $60.26 | $64.57 | $64.57 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | JW · Drug discarded | $57.54 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $63.10 | Professional | None | $38.02 | $63.10 | $63.10 |
Health Alliance Plan Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $186.21 | Facility | None | $48.98 | $102.33 | $186.21 |
Health Alliance Plan Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $83.18 | Professional | None | $58.88 | $63.10 | $83.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $29.51 | $29.51 | $29.51 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
Priority Health Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $63.10 | Professional | None | $38.02 | $38.90 | $63.10 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
1 more rate 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 |
|---|---|---|---|---|---|
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $81.28 Median $154.88 Typical High $173.78 | Facility | JZ · No drug discarded | $81.28 | $154.88 | $173.78 |
Where Michigan sits
Rates are fairly even across states for this service. 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· 5th 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.