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 $5.01 Median $5.01 Typical High $6.31 | Facility | None | $5.01 | $5.01 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $5.01 Typical High $17.78 | Professional | None | $3.02 | $5.01 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $11.75 | Professional | None | $10.00 | $10.00 | $11.75 |
BCBS Michigan Setting Facility Modifier None Typical Low $14.13 Median $28.18 Typical High $58.88 | Facility | None | $14.13 | $28.18 | $58.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $14.13 | Professional | None | $12.88 | $13.49 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $18.62 | Professional | None | $12.02 | $15.85 | $18.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $5.25 Median $18.20 Typical High $33.11 | Facility | None | $5.25 | $18.20 | $33.11 |
Health Alliance Plan Setting Professional Modifier None Typical Low $5.01 Median $12.02 Typical High $19.95 | Professional | None | $5.01 | $12.02 | $19.95 |
Priority Health Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $18.62 | Professional | None | $12.02 | $15.85 | $18.62 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.22 Typical High $17.38 | Professional | None | $7.76 | $11.22 | $17.38 |
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 $1.51 Median $2.51 Typical High $5.89 | Professional | 52 · Reduced service | $1.51 | $2.51 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $1.00 Typical High $2.34 | Professional | 53 · Discontinued | $0.60 | $1.00 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.76 Typical High $1.78 | Professional | 55 · Aftercare only | $0.45 | $0.76 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.50 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.30 | $0.50 | $1.20 |
Where Michigan sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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· 20th of 51
$12.88
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.