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 $7.76 Median $21.88 Typical High $24.55 | Facility | None | $7.76 | $21.88 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $20.89 | Professional | None | $7.76 | $7.76 | $20.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $7.76 Median $15.49 Typical High $28.84 | Facility | None | $7.76 | $15.49 | $28.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $8.32 | Professional | None | $7.08 | $7.59 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $8.32 | Professional | None | $3.63 | $3.63 | $8.32 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.71 Median $21.88 Typical High $25.12 | Facility | None | $8.71 | $21.88 | $25.12 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.76 Median $8.71 Typical High $11.75 | Professional | None | $7.76 | $8.71 | $11.75 |
Priority Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $8.32 | Professional | None | $3.63 | $3.63 | $8.32 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | None | $8.13 | $8.13 | $10.96 |
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 $3.89 Median $3.89 Typical High $10.47 | Professional | 52 · Reduced service | $3.89 | $3.89 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $4.17 | Professional | 53 · Discontinued | $1.55 | $1.55 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $3.16 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $2.09 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $6.76 Median $7.08 Typical High $7.41 | Professional | JW · Drug discarded | $6.76 | $7.08 | $7.41 |
Where Michigan sits
The same service costs 3.5 times more in Arizona than in Arkansas. 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· 39th of 51
$8.13
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.