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 $32.36 Median $33.88 Typical High $102.33 | Facility | None | $32.36 | $33.88 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $102.33 | Professional | None | $31.62 | $32.36 | $102.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $33.88 Median $66.07 Typical High $125.89 | Facility | None | $33.88 | $66.07 | $125.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $35.48 | Professional | None | $30.90 | $32.36 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $57.54 | Professional | None | $31.62 | $57.54 | $57.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $32.36 Median $67.61 Typical High $102.33 | Facility | None | $32.36 | $67.61 | $102.33 |
Health Alliance Plan Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $48.98 | Professional | None | $31.62 | $33.11 | $48.98 |
Priority Health Setting Professional Modifier None Typical Low $31.62 Median $57.54 Typical High $57.54 | Professional | None | $31.62 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
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 $15.85 Median $16.22 Typical High $51.29 | Professional | 52 · Reduced service | $15.85 | $16.22 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.61 Typical High $20.42 | Professional | 53 · Discontinued | $6.31 | $6.61 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $15.14 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $10.23 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | JW · Drug discarded | $28.84 | $30.20 | $31.62 |
Where Michigan sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 22nd of 51
$33.11
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.