How much rates vary
Facilitymedian $170 · 10th to 90th $89 to $355Professionalmedian $87 · 10th to 90th $54 to $120
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 $53.70 Median $72.44 Typical High $114.82 | Facility | None | $53.70 | $72.44 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $114.82 | Professional | None | $53.70 | $79.43 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $363.08 | Facility | None | $125.89 | $162.18 | $363.08 |
BCBS Michigan Setting Professional Modifier None Typical Low $36.31 Median $87.10 Typical High $162.18 | Professional | None | $36.31 | $87.10 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $107.15 | Professional | None | $75.86 | $79.43 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $141.25 | Professional | None | $39.81 | $72.44 | $141.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $63.10 Median $229.09 Typical High $338.84 | Facility | None | $63.10 | $229.09 | $338.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $123.03 | Professional | None | $57.54 | $104.71 | $123.03 |
Priority Health Setting Professional Modifier None Typical Low $34.67 Median $69.18 Typical High $114.82 | Professional | None | $34.67 | $69.18 | $114.82 |
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 $52.48 Median $83.18 Typical High $107.15 | Professional | None | $52.48 | $83.18 | $107.15 |
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 $26.92 Median $38.90 Typical High $54.95 | Professional | 52 · Reduced service | $26.92 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $21.88 | Professional | 53 · Discontinued | $10.72 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.48 Typical High $16.60 | Professional | 55 · Aftercare only | $8.13 | $11.48 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $10.96 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $151.36 Typical High $239.88 | Professional | 50 · Both sides | $93.33 | $151.36 | $239.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $36.31 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $36.31 | $54.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.45 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $14.45 | $21.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.72 Typical High $16.22 | Professional | 55 · Aftercare only | $8.32 | $10.72 | $16.22 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.24 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.50 | $7.24 | $10.96 |
Where Michigan sits
The same service costs 3.8 times more in Alaska than in Virginia. 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
$87.10
AK $214VA $56.23
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.