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 $11.75 Median $14.79 Typical High $37.15 | Facility | None | $11.75 | $14.79 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $12.59 | Professional | None | $11.22 | $11.75 | $12.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $11.48 Median $14.13 Typical High $40.74 | Facility | None | $11.48 | $14.13 | $40.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $11.48 | Professional | None | $9.77 | $10.23 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | None | $11.48 | $12.59 | $12.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $13.49 Median $33.11 Typical High $45.71 | Facility | None | $13.49 | $33.11 | $45.71 |
Health Alliance Plan Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $15.49 | Professional | None | $11.48 | $12.02 | $15.49 |
Priority Health Setting Professional Modifier None Typical Low $11.48 Median $12.59 Typical High $12.59 | Professional | None | $11.48 | $12.59 | $12.59 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $15.49 | Professional | None | $11.75 | $11.75 | $15.49 |
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 $5.62 Median $5.89 Typical High $6.17 | Professional | 52 · Reduced service | $5.62 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.34 Typical High $2.45 | Professional | 53 · Discontinued | $2.29 | $2.34 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.78 Typical High $1.82 | Professional | 55 · Aftercare only | $1.70 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.17 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.12 | $1.17 | $1.23 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $9.33 Median $9.77 Typical High $10.23 | Professional | JW · Drug discarded | $9.33 | $9.77 | $10.23 |
Where Michigan sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 32nd of 51
$12.02
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.