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 $426.58 Median $1,122.02 Typical High $1,258.93 | Facility | None | $426.58 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
BCBS Michigan Setting Facility Modifier None Typical Low $436.52 Median $851.14 Typical High $1,621.81 | Facility | None | $436.52 | $851.14 | $1,621.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | None | $398.11 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $707.95 | Professional | None | $426.58 | $467.74 | $707.95 |
Health Alliance Plan Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $1,258.93 | Facility | None | $436.52 | $1,096.48 | $1,258.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | None | $407.38 | $407.38 | $549.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Priority Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $457.09 | Professional | None | $389.05 | $436.52 | $457.09 |
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 JW · Drug discarded Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | JW · Drug discarded | $346.74 | $346.74 | $346.74 |
Where Michigan sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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
$417
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.