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 $549.54 Median $1,513.56 Typical High $1,698.24 | Facility | None | $549.54 | $1,513.56 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $1,584.89 | Professional | None | $537.03 | $549.54 | $1,584.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,148.15 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,122.02 | Professional | None | $537.03 | $1,122.02 | $1,122.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $794.33 Median $1,445.44 Typical High $1,698.24 | Facility | None | $794.33 | $1,445.44 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $812.83 | Professional | None | $537.03 | $562.34 | $812.83 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,122.02 | Professional | None | $537.03 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
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 $269.15 Median $275.42 Typical High $794.33 | Professional | 52 · Reduced service | $269.15 | $275.42 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $323.59 | Professional | 53 · Discontinued | $107.15 | $109.65 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $239.88 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $158.49 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $158.49 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $1,047.13 Median $1,096.48 Typical High $1,148.15 | Professional | JW · Drug discarded | $1,047.13 | $1,096.48 | $1,148.15 |
Where Michigan sits
The same service costs 5.0 times more in Wyoming 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· 14th of 51
$603
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.