How much rates vary
Facilitymedian $71 · 10th to 90th $58 to $178Professionalmedian $58 · 10th to 90th $56 to $74
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 $58.88 Median $60.26 Typical High $177.83 | Facility | None | $58.88 | $60.26 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | None | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $204.17 | Facility | None | $57.54 | $77.62 | $204.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | None | $54.95 | $57.54 | $57.54 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | JW · Drug discarded | $52.48 | $54.95 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $165.96 | Facility | None | $56.23 | $83.18 | $165.96 |
Health Alliance Plan Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $75.86 | Professional | None | $56.23 | $57.54 | $75.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
Priority Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $64.57 | Professional | None | $54.95 | $61.66 | $64.57 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | JZ · No drug discarded | $54.95 | $54.95 | $54.95 |
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· 29th of 51
$57.54
AK $70.79NJ $57.54
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.