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 $87.10 Median $112.20 Typical High $162.18 | Facility | None | $87.10 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $134.90 | Professional | None | $87.10 | $100.00 | $134.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $549.54 | Facility | None | $190.55 | $239.88 | $549.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $14.79 Median $109.65 Typical High $131.83 | Professional | None | $14.79 | $109.65 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $162.18 | Professional | None | $57.54 | $93.33 | $162.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $512.86 | Facility | None | $85.11 | $147.91 | $512.86 |
Health Alliance Plan Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $134.90 | Professional | None | $89.13 | $112.20 | $134.90 |
Priority Health Setting Professional Modifier None Typical Low $56.23 Median $85.11 Typical High $131.83 | Professional | None | $56.23 | $85.11 | $131.83 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $120.23 | Professional | None | $75.86 | $95.50 | $120.23 |
9 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 $43.65 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $43.65 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.20 Typical High $25.70 | Professional | 53 · Discontinued | $17.38 | $18.20 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $19.05 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $12.88 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $199.53 Typical High $199.53 | Professional | 50 · Both sides | $117.49 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $44.67 Typical High $63.10 | Professional | 52 · Reduced service | $43.65 | $44.67 | $63.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.78 Typical High $25.12 | Professional | 53 · Discontinued | $17.38 | $17.78 | $25.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $19.05 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $19.05 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $12.59 |
Where Michigan sits
The same service costs 3.6 times more in Alaska 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· 23rd of 51
$110
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.