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 $25.12 Median $25.12 Typical High $93.33 | Facility | None | $25.12 | $25.12 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $56.23 Typical High $93.33 | Professional | None | $24.55 | $56.23 | $93.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $28.18 Typical High $46.77 | Professional | 52 · Reduced service | $12.30 | $28.18 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $11.22 Typical High $19.05 | Professional | 53 · Discontinued | $4.90 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $8.32 Typical High $14.13 | Professional | 55 · Aftercare only | $3.72 | $8.32 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $5.62 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.45 | $5.62 | $9.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $131.83 | Professional | None | $25.70 | $29.51 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $53.70 Typical High $102.33 | Professional | None | $15.85 | $53.70 | $102.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $24.55 Median $199.53 Typical High $218.78 | Facility | None | $24.55 | $199.53 | $218.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $24.55 Median $74.13 Typical High $97.72 | Professional | None | $24.55 | $74.13 | $97.72 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $15.49 Typical High $46.77 | Professional | 52 · Reduced service | $12.30 | $15.49 | $46.77 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.17 Typical High $18.62 | Professional | 53 · Discontinued | $4.90 | $6.17 | $18.62 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.57 Typical High $13.80 | Professional | 55 · Aftercare only | $3.72 | $4.57 | $13.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.09 Typical High $9.33 | Professional | 56 · Pre-op care only | $2.45 | $3.09 | $9.33 |
Priority Health Setting Professional Modifier None Typical Low $14.79 Median $52.48 Typical High $83.18 | Professional | None | $14.79 | $52.48 | $83.18 |
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 $21.38 Median $36.31 Typical High $81.28 | Professional | None | $21.38 | $36.31 | $81.28 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 10th of 51
$63.10
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.