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 $19.05 Median $20.42 Typical High $4,897.79 | Facility | None | $19.05 | $20.42 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $32.36 | Professional | None | $19.05 | $19.95 | $32.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $38.02 Median $79.43 Typical High $158.49 | Facility | None | $38.02 | $79.43 | $158.49 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $32.36 | Professional | None | $28.18 | $29.51 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $19.95 Median $53.70 Typical High $2,884.03 | Facility | None | $19.95 | $53.70 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $28.18 | Professional | None | $19.05 | $20.89 | $28.18 |
Priority Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | None | $11.48 | $11.48 | $13.18 |
United Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $131.83 | Facility | None | $47.86 | $63.10 | $131.83 |
United Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $33.88 | Professional | None | $20.89 | $23.44 | $33.88 |
5 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 $9.12 Median $9.55 Typical High $10.23 | Professional | 52 · Reduced service | $9.12 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.80 Typical High $4.07 | Professional | 53 · Discontinued | $3.63 | $3.80 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $3.09 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.91 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.82 | $1.91 | $2.04 |
Health Alliance Plan Setting Facility Modifier XU · Unusual separate service Typical Low $56.23 Median $89.13 Typical High $173.78 | Facility | XU · Unusual separate service | $56.23 | $89.13 | $173.78 |
Where Michigan sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 33rd of 51
$26.30
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.