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 $125.89 Median $177.83 Typical High $4,897.79 | Facility | None | $125.89 | $177.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $177.83 | Professional | None | $85.11 | $131.83 | $177.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $660.69 | Facility | None | $229.09 | $288.40 | $660.69 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $245.47 | Professional | None | $151.36 | $213.80 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $223.87 | Professional | None | $85.11 | $131.83 | $223.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $109.65 Median $302.00 Typical High $2,041.74 | Facility | None | $109.65 | $302.00 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $181.97 | Professional | None | $95.50 | $138.04 | $181.97 |
Priority Health Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $186.21 | Professional | None | $81.28 | $125.89 | $186.21 |
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 $114.82 Median $138.04 Typical High $173.78 | Professional | None | $114.82 | $138.04 | $173.78 |
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 $63.10 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $17.78 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $371.54 Typical High $371.54 | Professional | 50 · Both sides | $229.09 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $63.10 | $66.07 | $89.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.30 | $35.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $17.78 |
Where Michigan sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 26th of 51
$151
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.