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 $1,258.93 Median $1,621.81 Typical High $3,981.07 | Facility | None | $1,258.93 | $1,621.81 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $4,677.35 | Facility | None | $1,288.25 | $2,398.83 | $4,677.35 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,288.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $3,630.78 | Facility | None | $1,258.93 | $2,454.71 | $3,630.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,348.96 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | None | $977.24 | $977.24 | $1,288.25 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,258.93 | $1,698.24 |
6 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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1,148.15 Median $1,202.26 Typical High $1,258.93 | Professional | JW · Drug discarded | $1,148.15 | $1,202.26 | $1,258.93 |
Where Michigan sits
The same service costs 2.9 times more in Minnesota than in Alabama. 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· 11th of 51
$1,318
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.