How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $72.44 Median $74.13 Typical High $144.54 | Facility | None | $72.44 | $74.13 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $144.54 | Professional | None | $70.79 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $42.66 Typical High $72.44 | Professional | 52 · Reduced service | $35.48 | $42.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $28.84 | Professional | 53 · Discontinued | $14.45 | $16.98 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $21.38 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $14.45 |
BCBS Michigan Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $186.21 | Professional | None | $75.86 | $81.28 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $89.13 Typical High $186.21 | Professional | None | $45.71 | $89.13 | $186.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $70.79 Median $295.12 Typical High $323.59 | Facility | None | $70.79 | $295.12 | $323.59 |
Health Alliance Plan Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $147.91 | Professional | None | $70.79 | $128.82 | $147.91 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $39.81 Typical High $69.18 | Professional | 52 · Reduced service | $35.48 | $39.81 | $69.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.22 Typical High $27.54 | Professional | 53 · Discontinued | $14.13 | $16.22 | $27.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.02 Typical High $20.89 | Professional | 55 · Aftercare only | $10.47 | $12.02 | $20.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $13.80 |
Priority Health Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $151.36 | Professional | None | $42.66 | $87.10 | $151.36 |
United Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $371.54 | Facility | None | $138.04 | $177.83 | $371.54 |
United Setting Professional Modifier None Typical Low $36.31 Median $74.13 Typical High $128.82 | Professional | None | $36.31 | $74.13 | $128.82 |
1 more rate 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 |
|---|---|---|---|---|---|
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Michigan sits
The same service costs 2.8 times more in Alaska than in Maryland. 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
$83.18
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.