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 $120.23 Median $331.13 Typical High $371.54 | Facility | None | $120.23 | $331.13 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $371.54 | Professional | None | $120.23 | $120.23 | $371.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $128.82 Median $257.04 Typical High $478.63 | Facility | None | $128.82 | $257.04 | $478.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | None | $117.49 | $123.03 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $134.90 Median $331.13 Typical High $467.74 | Facility | None | $134.90 | $331.13 | $467.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $223.87 | Professional | None | $120.23 | $158.49 | $223.87 |
Priority Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
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 $60.26 Median $60.26 Typical High $186.21 | Professional | 52 · Reduced service | $60.26 | $60.26 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $74.13 | Professional | 53 · Discontinued | $23.99 | $23.99 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $56.23 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $37.15 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $109.65 Median $114.82 Typical High $123.03 | Professional | JW · Drug discarded | $109.65 | $114.82 | $123.03 |
Where Michigan sits
The same service costs 2.3 times more in Texas than in Hawaii. 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· 12th of 51
$135
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.