How much rates vary
Facilitymedian $316 · 10th to 90th $107 to $617Professionalmedian $112 · 10th to 90th $76 to $151
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 $112.20 Median $114.82 Typical High $147.91 | Facility | None | $112.20 | $114.82 | $147.91 |
Aetna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $117.49 Typical High $117.49 | Professional | None (both parts) | $87.10 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $64.57 Typical High $64.57 | Professional | 26 · Professional part | $44.67 | $64.57 | $64.57 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | TC · Technical part | $43.65 | $51.29 | $56.23 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 26 · Professional part | $48.98 | $54.95 | $54.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $316.23 Median $323.59 Typical High $549.54 | Facility | None | $316.23 | $323.59 | $549.54 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $51.29 Median $123.03 Typical High $144.54 | Professional | None (both parts) | $51.29 | $123.03 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $60.26 Median $107.15 Typical High $331.13 | Professional | None (both parts) | $60.26 | $107.15 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $61.66 Median $177.83 Typical High $537.03 | Facility | None | $61.66 | $177.83 | $537.03 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $93.33 Median $109.65 Typical High $154.88 | Professional | None (both parts) | $93.33 | $109.65 | $154.88 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $50.12 Median $61.66 Typical High $83.18 | Professional | 26 · Professional part | $50.12 | $61.66 | $83.18 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $50.12 Typical High $69.18 | Professional | TC · Technical part | $42.66 | $50.12 | $69.18 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $60.26 Median $104.71 Typical High $162.18 | Professional | None (both parts) | $60.26 | $104.71 | $162.18 |
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 (both parts) Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None (both parts) | $97.72 | $109.65 | $138.04 |
United Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $60.26 Typical High $79.43 | Professional | 26 · Professional part | $54.95 | $60.26 | $79.43 |
United Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $48.98 Typical High $66.07 | Professional | TC · Technical part | $41.69 | $48.98 | $66.07 |
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 $46.77 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $46.77 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $13.80 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $11.75 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $16.60 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $10.96 |
Where Michigan sits
The same service costs 5.9 times more in Alaska than in Alabama. 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· 28th of 51
$117
AK $331AL $56.23
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.