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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | None | $28.84 | $28.84 | $33.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $28.84 Median $53.70 Typical High $112.20 | Facility | None | $28.84 | $53.70 | $112.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $31.62 | Professional | None | $26.92 | $28.84 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | None | $26.92 | $26.92 | $31.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $89.13 | Facility | None | $28.84 | $39.81 | $89.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $42.66 | Professional | None | $28.84 | $30.90 | $42.66 |
Priority Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | None | $26.92 | $26.92 | $31.62 |
United Setting Facility Modifier None Typical Low $28.84 Median $30.90 Typical High $30.90 | Facility | None | $28.84 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $41.69 | Professional | None | $32.36 | $38.90 | $41.69 |
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 $14.45 Median $14.45 Typical High $15.14 | Professional | 52 · Reduced service | $14.45 | $14.45 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 53 · Discontinued | $5.75 | $5.75 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $3.09 |
Where Michigan sits
The same service costs 1.6 times more in Arizona 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· 46th of 51
$30.90
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.