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 $239.88 Median $660.69 Typical High $741.31 | Facility | None | $239.88 | $660.69 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | None | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $25.70 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $512.86 Typical High $977.24 | Facility | None | $251.19 | $512.86 | $977.24 |
BCBS Michigan Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $269.15 Median $660.69 Typical High $933.25 | Facility | None | $269.15 | $660.69 | $933.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $354.81 | Professional | None | $239.88 | $257.04 | $354.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $120.23 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $47.86 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $38.02 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $25.70 |
Priority Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $263.03 | Professional | None | $100.00 | $251.19 | $263.03 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | JW · Drug discarded | $223.87 | $234.42 | $234.42 |
Where Michigan sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 21st of 51
$257
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.