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 $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | None | $223.87 | $239.88 | $257.04 |
BCBS Michigan Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $501.19 | Facility | None | $162.18 | $213.80 | $501.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $363.08 | Professional | None | $316.23 | $338.84 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $331.13 | Professional | None | $154.88 | $213.80 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $257.04 Median $489.78 Typical High $537.03 | Facility | None | $257.04 | $489.78 | $537.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $257.04 | Professional | None | $181.97 | $239.88 | $257.04 |
Priority Health Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $331.13 | Professional | None | $147.91 | $208.93 | $331.13 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $263.03 | Professional | None | $181.97 | $213.80 | $263.03 |
8 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 $112.20 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $23.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where Michigan sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 29th of 51
$240
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.