How much rates vary
Facilitymedian $51 · 10th to 90th $39 to $102Professionalmedian $48 · 10th to 90th $37 to $65
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 $37.15 Median $50.12 Typical High $51.29 | Facility | None | $37.15 | $50.12 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $42.66 Typical High $69.18 | Professional | None | $37.15 | $42.66 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $52.48 | Professional | None | $38.90 | $43.65 | $52.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $61.66 | Facility | None | $44.67 | $52.48 | $61.66 |
BCBS Michigan Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $61.66 | Professional | None | $48.98 | $52.48 | $61.66 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $75.86 | Professional | None | $46.77 | $63.10 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $97.72 | Professional | None | $33.11 | $43.65 | $97.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $38.90 Median $51.29 Typical High $112.20 | Facility | None | $38.90 | $51.29 | $112.20 |
Health Alliance Plan Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $70.79 | Professional | None | $38.02 | $46.77 | $70.79 |
Priority Health Setting Professional Modifier None Typical Low $32.36 Median $41.69 Typical High $97.72 | Professional | None | $32.36 | $41.69 | $97.72 |
United Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $54.95 | Professional | None | $36.31 | $42.66 | $54.95 |
13 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 $20.89 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.17 | $5.01 | $5.01 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | 24 · Unrelated visit after surgery | $37.15 | $37.15 | $43.65 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 25 · Same-day visit | $43.65 | $43.65 | $43.65 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 93 · Audio-only telehealth | $45.71 | $45.71 | $45.71 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | AM · Physician, team member | $45.71 | $45.71 | $45.71 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $33.88 Median $74.13 Typical High $109.65 | Professional | 25 · Same-day visit | $33.88 | $74.13 | $109.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Health Alliance Plan Setting Professional Modifier FS · Shared visit Typical Low $7.59 Median $48.98 Typical High $75.86 | Professional | FS · Shared visit | $7.59 | $48.98 | $75.86 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $47.86 Median $83.18 Typical High $100.00 | Professional | GC · Resident with teaching physician | $47.86 | $83.18 | $100.00 |
Where Michigan sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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
$48.98
AK $100NJ $37.15
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.