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 $5.75 Median $16.98 Typical High $19.05 | Facility | None | $5.75 | $16.98 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | None | $5.62 | $5.75 | $5.75 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.17 Median $10.72 Typical High $20.89 | Facility | None | $6.17 | $10.72 | $20.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.88 Median $6.17 Typical High $6.46 | Professional | None | $2.88 | $6.17 | $6.46 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $2.69 Median $5.75 Typical High $6.03 | Professional | JW · Drug discarded | $2.69 | $5.75 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $18.20 Typical High $18.20 | Professional | None | $5.62 | $18.20 | $18.20 |
Health Alliance Plan Setting Facility Modifier None Typical Low $6.03 Median $16.22 Typical High $19.50 | Facility | None | $6.03 | $16.22 | $19.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.62 Median $6.03 Typical High $8.71 | Professional | None | $5.62 | $6.03 | $8.71 |
Priority Health Setting Professional Modifier None Typical Low $5.62 Median $18.20 Typical High $18.20 | Professional | None | $5.62 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $7.76 | Professional | None | $5.89 | $5.89 | $7.76 |
4 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 $2.82 Median $2.88 Typical High $9.33 | Professional | 52 · Reduced service | $2.82 | $2.88 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.15 Typical High $3.80 | Professional | 53 · Discontinued | $1.12 | $1.15 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.87 Typical High $2.82 | Professional | 55 · Aftercare only | $0.83 | $0.87 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.58 Typical High $1.91 | Professional | 56 · Pre-op care only | $0.56 | $0.58 | $1.91 |
Where Michigan sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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· 16th of 51
$6.46
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.