How much rates vary
Facilitymedian $138 · 10th to 90th $102 to $245Professionalmedian $145 · 10th to 90th $105 to $200
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 $102.33 Median $138.04 Typical High $169.82 | Facility | None | $102.33 | $138.04 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $169.82 | Professional | None | $102.33 | $134.90 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $213.80 | Professional | None | $97.72 | $151.36 | $213.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $389.05 | Facility | None | $117.49 | $194.98 | $389.05 |
BCBS Michigan Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $208.93 | Professional | None | $144.54 | $165.96 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $245.47 | Professional | None | $154.88 | $208.93 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $229.09 | Professional | None | $123.03 | $151.36 | $229.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $63.10 Median $134.90 Typical High $190.55 | Facility | None | $63.10 | $134.90 | $190.55 |
Health Alliance Plan Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $223.87 | Professional | None | $104.71 | $144.54 | $223.87 |
Priority Health Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Priority Health Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $181.97 | Professional | None | $125.89 | $151.36 | $181.97 |
United Setting Professional Modifier None Typical Low $120.23 Median $144.54 Typical High $181.97 | Professional | None | $120.23 | $144.54 | $181.97 |
19 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 $67.61 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $16.98 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $128.82 Median $169.82 Typical High $234.42 | Professional | 25 · Same-day visit | $128.82 | $169.82 | $234.42 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 57 · Decision for surgery | $245.47 | $245.47 | $257.04 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 93 · Audio-only telehealth | $114.82 | $114.82 | $123.03 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | FS · Shared visit | $165.96 | $165.96 | $165.96 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $144.54 Median $158.49 Typical High $234.42 | Professional | GC · Resident with teaching physician | $144.54 | $158.49 | $234.42 |
Ambetter Setting Professional Modifier GE · Resident, primary care exception Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | GE · Resident, primary care exception | $186.21 | $186.21 | $186.21 |
BCBS Michigan Setting Professional Modifier HO · Master's level Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | HO · Master's level | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $213.80 Typical High $457.09 | Professional | 25 · Same-day visit | $91.20 | $213.80 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $69.18 | $69.18 | $85.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $25.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.98 |
Health Alliance Plan Setting Professional Modifier 57 · Decision for surgery Typical Low $112.20 Median $173.78 Typical High $309.03 | Professional | 57 · Decision for surgery | $112.20 | $173.78 | $309.03 |
Health Alliance Plan Setting Professional Modifier FS · Shared visit Typical Low $131.83 Median $173.78 Typical High $194.98 | Professional | FS · Shared visit | $131.83 | $173.78 | $194.98 |
Health Alliance Plan Setting Professional Modifier GA · Liability notice issued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | GA · Liability notice issued | $158.49 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $138.04 Median $257.04 Typical High $316.23 | Professional | GC · Resident with teaching physician | $138.04 | $257.04 | $316.23 |
Health Alliance Plan Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | GF · Non-physician, rural hospital | $380.19 | $380.19 | $380.19 |
Where Michigan sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$145
AK $263AL $115
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.