How much rates vary
Facilitymedian $214 · 10th to 90th $117 to $427Professionalmedian $155 · 10th to 90th $117 to $182
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 $117.49 Median $123.03 Typical High $162.18 | Facility | None | $117.49 | $123.03 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $154.88 | Professional | None | $117.49 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $77.62 | Professional | 52 · Reduced service | $58.88 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $223.87 | Professional | None | $120.23 | $154.88 | $223.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $131.83 Median $257.04 Typical High $478.63 | Facility | None | $131.83 | $257.04 | $478.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $181.97 | Professional | None | $154.88 | $169.82 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $218.78 | Professional | None | $138.04 | $186.21 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $281.84 | Professional | None | $97.72 | $141.25 | $281.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $89.13 Median $162.18 Typical High $426.58 | Facility | None | $89.13 | $162.18 | $426.58 |
Health Alliance Plan Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $199.53 | Professional | None | $120.23 | $154.88 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $60.26 | $77.62 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $22.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $15.49 |
Priority Health Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $208.93 | Professional | None | $93.33 | $131.83 | $208.93 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $169.82 | Professional | None | $107.15 | $134.90 | $169.82 |
4 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 $151.36 Typical High $204.17 | Professional | 25 · Same-day visit | $120.23 | $151.36 | $204.17 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | GC · Resident with teaching physician | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $154.88 Median $234.42 Typical High $467.74 | Professional | 25 · Same-day visit | $154.88 | $234.42 | $467.74 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | GC · Resident with teaching physician | $186.21 | $186.21 | $234.42 |
Where Michigan sits
The same service costs 2.7 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· 20th of 51
$155
AK $295DC $110
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.