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 $19.95 Median $53.70 Typical High $60.26 | Facility | None | $19.95 | $53.70 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.95 Typical High $38.02 | Professional | None | $19.50 | $19.95 | $38.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $20.42 Median $39.81 Typical High $75.86 | Facility | None | $20.42 | $39.81 | $75.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $21.38 | Professional | None | $18.62 | $19.50 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $21.38 Median $52.48 Typical High $60.26 | Facility | None | $21.38 | $52.48 | $60.26 |
Health Alliance Plan Setting Professional Modifier None Typical Low $19.05 Median $19.50 Typical High $26.30 | Professional | None | $19.05 | $19.50 | $26.30 |
Priority Health Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | None | $18.62 | $18.62 | $25.12 |
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 $9.55 Median $10.00 Typical High $15.85 | Professional | 52 · Reduced service | $9.55 | $10.00 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.98 Typical High $6.46 | Professional | 53 · Discontinued | $3.89 | $3.98 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.95 Typical High $4.79 | Professional | 55 · Aftercare only | $2.88 | $2.95 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.00 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.95 | $2.00 | $3.24 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $17.38 Median $18.62 Typical High $19.50 | Professional | JW · Drug discarded | $17.38 | $18.62 | $19.50 |
Where Michigan sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 27th of 51
$19.50
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.