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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $24.55 | Professional | None | $18.62 | $18.62 | $24.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $18.62 Median $34.67 Typical High $72.44 | Facility | None | $18.62 | $34.67 | $72.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.38 Median $18.62 Typical High $20.42 | Professional | None | $17.38 | $18.62 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $20.42 | Professional | None | $17.78 | $17.78 | $20.42 |
Health Alliance Plan Setting Facility Modifier None Typical Low $18.62 Median $26.92 Typical High $77.62 | Facility | None | $18.62 | $26.92 | $77.62 |
Health Alliance Plan Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $28.84 | Professional | None | $18.62 | $20.42 | $28.84 |
Priority Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $20.42 | Professional | None | $17.78 | $17.78 | $20.42 |
United Setting Facility Modifier None Typical Low $19.50 Median $20.89 Typical High $20.89 | Facility | None | $19.50 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $26.30 | Professional | None | $20.89 | $25.12 | $26.30 |
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 $9.33 Median $9.33 Typical High $10.23 | Professional | 52 · Reduced service | $9.33 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $4.07 | Professional | 53 · Discontinued | $3.72 | $3.72 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.04 |
Where Michigan sits
The same service costs 2.1 times more in Alabama than in Rhode Island. 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
$20.42
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.