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 $87.10 Median $87.10 Typical High $123.03 | Facility | None | $87.10 | $87.10 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $123.03 | Professional | None | $85.11 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $45.71 Typical High $61.66 | Professional | 52 · Reduced service | $42.66 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $12.30 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $123.03 | Professional | None | $100.00 | $120.23 | $123.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $120.23 Median $234.42 Typical High $416.87 | Facility | None | $120.23 | $234.42 | $416.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $144.54 | Professional | None | $123.03 | $138.04 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $173.78 | Professional | None | $107.15 | $144.54 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $208.93 | Professional | None | $72.44 | $107.15 | $208.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $87.10 Median $302.00 Typical High $338.84 | Facility | None | $87.10 | $302.00 | $338.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $151.36 | Professional | None | $87.10 | $123.03 | $151.36 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $44.67 | $60.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $13.18 | $13.49 | $18.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $12.30 |
Priority Health Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $165.96 | Professional | None | $69.18 | $100.00 | $165.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $134.90 | Professional | None | $75.86 | $102.33 | $134.90 |
2 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 $120.23 Median $123.03 Typical High $123.03 | Professional | 25 · Same-day visit | $120.23 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $181.97 Typical High $416.87 | Professional | 25 · Same-day visit | $120.23 | $181.97 | $416.87 |
Where Michigan sits
The same service costs 2.8 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· 21st of 51
$123
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.