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 $147.91 Median $2,041.74 Typical High $4,897.79 | Facility | None | $147.91 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $151.36 | Professional | None | $120.23 | $147.91 | $151.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,659.59 | Facility | None | $1,047.13 | $1,230.27 | $1,659.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $173.78 | Professional | None | $147.91 | $158.49 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $147.91 Median $338.84 Typical High $4,897.79 | Facility | None | $147.91 | $338.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $173.78 | Professional | None | $104.71 | $128.82 | $173.78 |
Priority Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $5,754.40 | Facility | None | $1,584.89 | $3,162.28 | $5,754.40 |
United Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $208.93 | Professional | None | $131.83 | $154.88 | $208.93 |
5 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 $60.26 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $89.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $14.79 | $15.14 |
Where Michigan sits
The same service costs 37.2 times more in Oklahoma than in New York. 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· 44th of 51
$158
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.