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 $89.13 Median $234.42 Typical High $263.03 | Facility | None | $89.13 | $234.42 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
BCBS Michigan Setting Facility Modifier None Typical Low $93.33 Median $186.21 Typical High $346.74 | Facility | None | $93.33 | $186.21 | $346.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | None | $83.18 | $87.10 | $87.10 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | JW · Drug discarded | $77.62 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $91.20 Median $213.80 Typical High $263.03 | Facility | None | $91.20 | $213.80 | $263.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | None | $85.11 | $85.11 | $114.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Priority Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $97.72 | Professional | None | $81.28 | $91.20 | $97.72 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.33 |
Where Michigan sits
Rates are fairly even across states for this service. 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
$87.10
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.