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 $69.18 Median $70.79 Typical High $104.71 | Facility | None | $69.18 | $70.79 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $100.00 | Professional | None | $67.61 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $33.88 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.48 Typical High $15.14 | Professional | 55 · Aftercare only | $10.23 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | None | $83.18 | $87.10 | $97.72 |
BCBS Michigan Setting Facility Modifier None Typical Low $144.54 Median $281.84 Typical High $501.19 | Facility | None | $144.54 | $281.84 | $501.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | None | $151.36 | $158.49 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $141.25 | Professional | None | $89.13 | $120.23 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $173.78 | Professional | None | $54.95 | $83.18 | $173.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $275.42 | Facility | None | $66.07 | $104.71 | $275.42 |
Health Alliance Plan Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $125.89 | Professional | None | $70.79 | $100.00 | $125.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $35.48 | $36.31 | $50.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $10.00 |
Priority Health Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $131.83 | Professional | None | $53.70 | $79.43 | $131.83 |
United Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $112.20 | Professional | None | $58.88 | $79.43 | $112.20 |
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 $83.18 Median $97.72 Typical High $125.89 | Professional | 25 · Same-day visit | $83.18 | $97.72 | $125.89 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $229.09 Typical High $331.13 | Professional | 25 · Same-day visit | $100.00 | $229.09 | $331.13 |
Where Michigan sits
The same service costs 2.9 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
$100
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.