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 $74.13 Median $100.00 Typical High $102.33 | Facility | None | $74.13 | $100.00 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $138.04 | Professional | None | $74.13 | $93.33 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $169.82 | Professional | None | $87.10 | $165.96 | $169.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $134.90 Median $213.80 Typical High $213.80 | Facility | None | $134.90 | $213.80 | $213.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $213.80 | Professional | None | $134.90 | $144.54 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $147.91 | Professional | None | $91.20 | $125.89 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $245.47 | Professional | None | $83.18 | $144.54 | $245.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $87.10 Median $102.33 Typical High $389.05 | Facility | None | $87.10 | $102.33 | $389.05 |
Health Alliance Plan Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $173.78 | Professional | None | $77.62 | $102.33 | $173.78 |
Priority Health Setting Professional Modifier None Typical Low $72.44 Median $134.90 Typical High $229.09 | Professional | None | $72.44 | $134.90 | $229.09 |
United Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $177.83 | Professional | None | $123.03 | $147.91 | $177.83 |
6 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 $48.98 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where Michigan sits
The same service costs 2.0 times more in Alaska 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· 35th of 51
$120
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.