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 $83.18 Median $107.15 Typical High $6,918.31 | Facility | None | $83.18 | $107.15 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | None | $83.18 | $83.18 | $109.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,715.35 | Facility | None | $2,344.23 | $2,691.53 | $3,715.35 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,380.38 | $2,187.76 | $2,187.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $102.33 Median $4,897.79 Typical High $6,918.31 | Facility | None | $102.33 | $4,897.79 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,011.87 Typical High $7,585.78 | Facility | None | $2,398.83 | $5,011.87 | $7,585.78 |
United Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $194.98 | Professional | None | $120.23 | $144.54 | $194.98 |
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 $41.69 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $41.69 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $16.60 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | 54 · Surgery only | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $16.22 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.96 |
Where Michigan sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 10th of 51
$1,380
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.