How much rates vary
Facilitymedian $148 · 10th to 90th $89 to $324Professionalmedian $120 · 10th to 90th $89 to $145
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 $89.13 Median $112.20 Typical High $151.36 | Facility | None | $89.13 | $112.20 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $120.23 | Professional | None | $89.13 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $44.67 | $44.67 | $60.26 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $123.03 | Professional | None | $93.33 | $104.71 | $123.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $112.20 Median $218.78 Typical High $389.05 | Facility | None | $112.20 | $218.78 | $389.05 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | None | $123.03 | $134.90 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $169.82 | Professional | None | $107.15 | $144.54 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $223.87 | Professional | None | $72.44 | $104.71 | $223.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $77.62 Median $114.82 Typical High $323.59 | Facility | None | $77.62 | $114.82 | $323.59 |
Health Alliance Plan Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $173.78 | Professional | None | $91.20 | $120.23 | $173.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $44.67 | $44.67 | $60.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $18.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $12.02 |
Priority Health Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $165.96 | Professional | None | $69.18 | $97.72 | $165.96 |
United Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $134.90 | Professional | None | $77.62 | $102.33 | $134.90 |
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 $83.18 Median $117.49 Typical High $123.03 | Professional | 25 · Same-day visit | $83.18 | $117.49 | $123.03 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $89.13 Median $89.13 Typical High $117.49 | Professional | GC · Resident with teaching physician | $89.13 | $89.13 | $117.49 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $186.21 Typical High $346.74 | Professional | 25 · Same-day visit | $117.49 | $186.21 | $346.74 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $147.91 Median $177.83 Typical High $199.53 | Professional | GC · Resident with teaching physician | $147.91 | $177.83 | $199.53 |
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· 21st of 51
$120
AK $224DC $83.18
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.