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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $30.90 | Professional | None | $21.88 | $22.39 | $30.90 |
BCBS Setting Facility Modifier None Typical Low $19.50 Median $38.02 Typical High $79.43 | Facility | None | $19.50 | $38.02 | $79.43 |
BCBS Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $21.88 | Professional | None | $18.62 | $19.50 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | None | $18.20 | $18.20 | $21.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $17.38 Median $33.11 Typical High $64.57 | Facility | None | $17.38 | $33.11 | $64.57 |
Health Alliance Plan Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $33.88 | Professional | None | $21.88 | $22.39 | $33.88 |
Priority Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | None | $18.20 | $18.20 | $21.88 |
United Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $28.84 | Professional | None | $22.39 | $26.30 | $28.84 |
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 $10.96 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where Michigan sits
The same service costs 1.9 times more in Alabama than in Georgia. 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· 38th of 51
$21.88
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.