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 $18.62 Median $56.23 Typical High $63.10 | Facility | None | $18.62 | $56.23 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $63.10 | Professional | None | $18.20 | $18.62 | $63.10 |
BCBS Michigan Setting Facility Modifier None Typical Low $19.05 Median $38.02 Typical High $70.79 | Facility | None | $19.05 | $38.02 | $70.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $20.42 | Professional | None | $17.38 | $18.20 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Health Alliance Plan Setting Facility Modifier None Typical Low $27.54 Median $48.98 Typical High $63.10 | Facility | None | $27.54 | $48.98 | $63.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $25.70 | Professional | None | $18.20 | $19.95 | $25.70 |
Priority Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $19.50 Median $21.88 Typical High $28.18 | Professional | None | $19.50 | $21.88 | $28.18 |
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 $9.12 Median $9.33 Typical High $30.90 | Professional | 52 · Reduced service | $9.12 | $9.33 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.72 Typical High $12.59 | Professional | 53 · Discontinued | $3.63 | $3.72 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.82 Typical High $9.33 | Professional | 55 · Aftercare only | $2.69 | $2.82 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.86 Typical High $6.31 | Professional | 56 · Pre-op care only | $1.82 | $1.86 | $6.31 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $16.60 Median $17.38 Typical High $18.20 | Professional | JW · Drug discarded | $16.60 | $17.38 | $18.20 |
Where Michigan sits
The same service costs 2.1 times more in Oklahoma than in Florida. 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· 26th of 51
$19.95
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.