How much rates vary
Facilitymedian $339 · 10th to 90th $166 to $562Professionalmedian $170 · 10th to 90th $162 to $209
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 $165.96 Median $169.82 Typical High $562.34 | Facility | None | $165.96 | $169.82 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | None | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $338.84 | Professional | None | $177.83 | $245.47 | $338.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $676.08 | Facility | None | $177.83 | $346.74 | $676.08 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | None | $162.18 | $169.82 | $169.82 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | JW · Drug discarded | $151.36 | $158.49 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $239.88 | Professional | None | $177.83 | $177.83 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $234.42 | Professional | None | $162.18 | $162.18 | $234.42 |
Health Alliance Plan Setting Facility Modifier None Typical Low $165.96 Median $346.74 Typical High $537.03 | Facility | None | $165.96 | $346.74 | $537.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $213.80 | Professional | None | $162.18 | $181.97 | $213.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Priority Health Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | None | $162.18 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $208.93 | Professional | None | $177.83 | $194.98 | $208.93 |
3 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 |
|---|---|---|---|---|---|
Health Alliance Plan Setting Facility Modifier JZ · No drug discarded Typical Low $316.23 Median $389.05 Typical High $1,023.29 | Facility | JZ · No drug discarded | $316.23 | $389.05 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier GA · Liability notice issued Typical Low $158.49 Median $165.96 Typical High $229.09 | Professional | GA · Liability notice issued | $158.49 | $165.96 | $229.09 |
Health Alliance Plan Setting Professional Modifier JZ · No drug discarded Typical Low $169.82 Median $181.97 Typical High $218.78 | Professional | JZ · No drug discarded | $169.82 | $181.97 | $218.78 |
Where Michigan sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 33rd of 51
$170
WY $302NV $162
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.