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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | None | $120.23 | $120.23 | $134.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $123.03 Median $229.09 Typical High $478.63 | Facility | None | $123.03 | $229.09 | $478.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | None | $117.49 | $123.03 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $138.04 | Professional | None | $89.13 | $89.13 | $138.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $31.62 Median $97.72 Typical High $120.23 | Facility | None | $31.62 | $97.72 | $120.23 |
Health Alliance Plan Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $120.23 | Professional | None | $37.15 | $44.67 | $120.23 |
Priority Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $138.04 | Professional | None | $89.13 | $89.13 | $138.04 |
United Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | None | $117.49 | $141.25 | $169.82 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where Michigan sits
The same service costs 5.1 times more in Arizona than in Alabama. 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· 27th of 51
$120
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.