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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $302.00 Median $562.34 Typical High $1,174.90 | Facility | None | $302.00 | $562.34 | $1,174.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | None | $288.40 | $302.00 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | None | $257.04 | $257.04 | $338.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $295.12 Median $346.74 Typical High $954.99 | Facility | None | $295.12 | $346.74 | $954.99 |
Health Alliance Plan Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $436.52 | Professional | None | $295.12 | $323.59 | $436.52 |
Priority Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $338.84 | Professional | None | $257.04 | $257.04 | $338.84 |
United Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $416.87 | Professional | None | $302.00 | $363.08 | $416.87 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $29.51 |
Where Michigan sits
The same service costs 22.9 times more in Arizona than in South Carolina. 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· 32nd of 51
$324
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.