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 $34.67 Median $75.86 Typical High $85.11 | Facility | None | $34.67 | $75.86 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $72.44 | Professional | None | $28.84 | $34.67 | $72.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $31.62 Median $63.10 Typical High $117.49 | Facility | None | $31.62 | $63.10 | $117.49 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $33.88 | Professional | None | $28.84 | $30.20 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $30.90 Median $75.86 Typical High $89.13 | Facility | None | $30.90 | $75.86 | $89.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $42.66 | Professional | None | $26.92 | $31.62 | $42.66 |
Priority Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
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 $14.45 Median $17.38 Typical High $36.31 | Professional | 52 · Reduced service | $14.45 | $17.38 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $14.45 | Professional | 53 · Discontinued | $5.75 | $7.08 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.25 Typical High $10.96 | Professional | 55 · Aftercare only | $4.37 | $5.25 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.47 Typical High $7.24 | Professional | 56 · Pre-op care only | $2.88 | $3.47 | $7.24 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $27.54 Median $28.84 Typical High $30.20 | Professional | JW · Drug discarded | $27.54 | $28.84 | $30.20 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 8th of 51
$33.88
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.