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 $12.02 Median $12.02 Typical High $15.14 | Facility | None | $12.02 | $12.02 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $29.51 | Professional | None | $10.00 | $12.02 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $29.51 | Professional | None | $17.78 | $21.88 | $29.51 |
BCBS Michigan Setting Facility Modifier None Typical Low $26.92 Median $53.70 Typical High $112.20 | Facility | None | $26.92 | $53.70 | $112.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $36.31 | Professional | None | $25.70 | $26.92 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $39.81 | Professional | None | $20.42 | $31.62 | $39.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $26.30 Median $63.10 Typical High $125.89 | Facility | None | $26.30 | $63.10 | $125.89 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.02 Median $25.70 Typical High $58.88 | Professional | None | $12.02 | $25.70 | $58.88 |
Priority Health Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $39.81 | Professional | None | $20.42 | $31.62 | $39.81 |
United Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $204.17 | Facility | None | $74.13 | $95.50 | $204.17 |
United Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $33.88 | Professional | None | $13.80 | $22.91 | $33.88 |
4 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 $5.01 Median $6.03 Typical High $11.75 | Professional | 52 · Reduced service | $5.01 | $6.03 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.40 Typical High $4.68 | Professional | 53 · Discontinued | $2.00 | $2.40 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.82 Typical High $3.47 | Professional | 55 · Aftercare only | $1.51 | $1.82 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.20 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.00 | $1.20 | $2.34 |
Where Michigan sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 12th of 51
$33.88
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.