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 $56.23 Median $58.88 Typical High $85.11 | Facility | None | $56.23 | $58.88 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $85.11 | Professional | None | $39.81 | $58.88 | $85.11 |
BCBS Michigan Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $134.90 | Facility | None | $46.77 | $60.26 | $134.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.23 Median $60.26 Typical High $112.20 | Professional | None | $10.23 | $60.26 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $100.00 | Professional | None | $37.15 | $61.66 | $100.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $190.55 | Facility | None | $50.12 | $58.88 | $190.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $87.10 | Professional | None | $43.65 | $64.57 | $87.10 |
Priority Health Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $87.10 | Professional | None | $36.31 | $54.95 | $87.10 |
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 $50.12 Median $63.10 Typical High $81.28 | Professional | None | $50.12 | $63.10 | $81.28 |
8 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 $28.18 Median $29.51 Typical High $42.66 | Professional | 52 · Reduced service | $28.18 | $29.51 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $11.75 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $8.51 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $28.18 | $29.51 | $41.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $16.60 | Professional | 53 · Discontinued | $11.48 | $11.75 | $16.60 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $12.59 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $8.32 |
Where Michigan sits
The same service costs 3.5 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· 38th of 51
$63.10
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.