How much rates vary
Facilitymedian $148 · 10th to 90th $85 to $331Professionalmedian $72 · 10th to 90th $45 to $95
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 $51.29 Median $66.07 Typical High $91.20 | Facility | None | $51.29 | $66.07 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $91.20 | Professional | None | $51.29 | $64.57 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $102.33 Median $131.83 Typical High $295.12 | Facility | None | $102.33 | $131.83 | $295.12 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.22 Median $91.20 Typical High $131.83 | Professional | None | $11.22 | $91.20 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $87.10 | Professional | None | $61.66 | $63.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $61.66 Typical High $109.65 | Professional | None | $33.88 | $61.66 | $109.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $61.66 Median $169.82 Typical High $316.23 | Facility | None | $61.66 | $169.82 | $316.23 |
Health Alliance Plan Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $97.72 | Professional | None | $53.70 | $81.28 | $97.72 |
Priority Health Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $95.50 | Professional | None | $32.36 | $54.95 | $95.50 |
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 $44.67 Median $63.10 Typical High $79.43 | Professional | None | $44.67 | $63.10 | $79.43 |
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 $25.70 Median $30.90 Typical High $43.65 | Professional | 52 · Reduced service | $25.70 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.30 Typical High $17.38 | Professional | 53 · Discontinued | $10.23 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.33 Typical High $13.18 | Professional | 55 · Aftercare only | $7.59 | $9.33 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.13 | $6.17 | $8.71 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $162.18 Typical High $194.98 | Professional | 50 · Both sides | $102.33 | $162.18 | $194.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $28.84 Typical High $42.66 | Professional | 52 · Reduced service | $25.70 | $28.84 | $42.66 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.48 Typical High $17.38 | Professional | 53 · Discontinued | $10.23 | $11.48 | $17.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.71 Typical High $12.88 | Professional | 55 · Aftercare only | $7.76 | $8.71 | $12.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.75 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.13 | $5.75 | $8.71 |
Where Michigan sits
The same service costs 4.0 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· 21st of 51
$74.13
AK $195KY $48.98
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.