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 $9.77 Median $9.77 Typical High $10.00 | Facility | None | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | None | $9.77 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.45 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.98 | $1.00 | $1.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $12.88 Median $30.90 Typical High $57.54 | Facility | None | $12.88 | $30.90 | $57.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.23 Median $10.72 Typical High $10.72 | Professional | None | $10.23 | $10.72 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | None | $5.13 | $5.13 | $5.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.13 Median $20.89 Typical High $22.91 | Facility | None | $8.13 | $20.89 | $22.91 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $10.47 | Professional | None | $7.76 | $8.13 | $10.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Priority Health Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | None | $5.13 | $5.13 | $5.50 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.01 Typical High $6.46 | Professional | None | $3.80 | $5.01 | $6.46 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | RR · Rental | $10.72 | $10.72 | $10.72 |
Where Michigan sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 12th of 51
$9.12
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.