How much rates vary
Facilitymedian $355 · 10th to 90th $110 to $2,399Professionalmedian $123 · 10th to 90th $105 to $166
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 $109.65 Median $120.23 Typical High $138.04 | Facility | None | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $128.82 | Professional | None | $109.65 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $104.71 | Professional | None | $89.13 | $100.00 | $104.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,479.11 | $1,737.80 | $3,467.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $165.96 | Professional | None | $147.91 | $154.88 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $181.97 | Professional | None | $109.65 | $144.54 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $245.47 | Professional | None | $93.33 | $117.49 | $245.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $112.20 Median $323.59 Typical High $676.08 | Facility | None | $112.20 | $323.59 | $676.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $158.49 | Professional | None | $112.20 | $123.03 | $158.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $12.30 |
Priority Health Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $204.17 | Professional | None | $89.13 | $114.82 | $204.17 |
United Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | None | $104.71 | $123.03 | $138.04 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 25 · Same-day visit | $104.71 | $104.71 | $104.71 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | FS · Shared visit | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $190.55 Typical High $371.54 | Professional | 25 · Same-day visit | $95.50 | $190.55 | $371.54 |
Health Alliance Plan Setting Professional Modifier FS · Shared visit Typical Low $87.10 Median $120.23 Typical High $194.98 | Professional | FS · Shared visit | $87.10 | $120.23 | $194.98 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $107.15 Median $190.55 Typical High $281.84 | Professional | GC · Resident with teaching physician | $107.15 | $190.55 | $281.84 |
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
$123
AK $263NJ $97.72
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.