How much rates vary
Facilitymedian $891 · 10th to 90th $60 to $2,188Professionalmedian $78 · 10th to 90th $36 to $282
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 $251.19 Typical High $323.59 | Facility | None | $56.23 | $251.19 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $162.18 Typical High $257.04 | Professional | None | $44.67 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $81.28 Typical High $128.82 | Professional | 52 · Reduced service | $28.18 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $32.36 Typical High $51.29 | Professional | 53 · Discontinued | $11.22 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $24.55 Typical High $38.90 | Professional | 55 · Aftercare only | $8.32 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $16.22 Typical High $25.70 | Professional | 56 · Pre-op care only | $5.62 | $16.22 | $25.70 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,238.72 | Facility | None | $758.58 | $1,047.13 | $2,238.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.48 Median $57.54 Typical High $346.74 | Professional | None | $11.48 | $57.54 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $141.25 Typical High $346.74 | Professional | None | $42.66 | $141.25 | $346.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $57.54 Median $758.58 Typical High $1,659.59 | Facility | None | $57.54 | $758.58 | $1,659.59 |
Health Alliance Plan Setting Professional Modifier None Typical Low $51.29 Median $218.78 Typical High $263.03 | Professional | None | $51.29 | $218.78 | $263.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $75.86 Typical High $131.83 | Professional | 52 · Reduced service | $28.18 | $75.86 | $131.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $23.99 Typical High $52.48 | Professional | 53 · Discontinued | $11.22 | $23.99 | $52.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $17.78 Typical High $38.90 | Professional | 55 · Aftercare only | $8.32 | $17.78 | $38.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $12.02 Typical High $26.30 | Professional | 56 · Pre-op care only | $5.62 | $12.02 | $26.30 |
Priority Health Setting Professional Modifier None Typical Low $42.66 Median $147.91 Typical High $295.12 | Professional | None | $42.66 | $147.91 | $295.12 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,089.30 | Facility | None | $302.00 | $1,288.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $51.29 Median $181.97 Typical High $263.03 | Professional | None | $51.29 | $181.97 | $263.03 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | GC · Resident with teaching physician | $58.88 | $58.88 | $58.88 |
Where Michigan sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 47th of 51
$112
NC $309HI $58.88
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.