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 $134.90 Median $346.74 Typical High $380.19 | Facility | None | $134.90 | $346.74 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $380.19 | Professional | None | $131.83 | $134.90 | $380.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $524.81 | Facility | None | $138.04 | $269.15 | $524.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | None | $123.03 | $131.83 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $45.71 Median $354.81 Typical High $389.05 | Facility | None | $45.71 | $354.81 | $389.05 |
Health Alliance Plan Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $204.17 | Professional | None | $123.03 | $138.04 | $204.17 |
Priority Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $173.78 | Professional | None | $120.23 | $131.83 | $173.78 |
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 $66.07 Median $67.61 Typical High $190.55 | Professional | 52 · Reduced service | $66.07 | $67.61 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $77.62 | Professional | 53 · Discontinued | $26.30 | $26.92 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.42 Typical High $57.54 | Professional | 55 · Aftercare only | $19.95 | $20.42 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $38.02 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $38.02 |
BCBS Michigan Setting Professional Modifier JW · Drug discarded Typical Low $117.49 Median $123.03 Typical High $128.82 | Professional | JW · Drug discarded | $117.49 | $123.03 | $128.82 |
Where Michigan sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 15th of 51
$135
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.