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 $8.91 Median $8.91 Typical High $9.33 | Facility | None | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | None | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.41 Typical High $1.41 | Professional | 55 · Aftercare only | $1.35 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.89 | $0.93 | $0.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $12.02 Median $28.84 Typical High $56.23 | Facility | None | $12.02 | $28.84 | $56.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | None | $9.55 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $6.31 Typical High $6.31 | Professional | None | $5.13 | $6.31 | $6.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $7.59 Median $8.32 Typical High $21.38 | Facility | None | $7.59 | $8.32 | $21.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $9.55 | Professional | None | $7.24 | $7.59 | $9.55 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $0.76 |
Priority Health Setting Professional Modifier None Typical Low $5.13 Median $6.31 Typical High $6.31 | Professional | None | $5.13 | $6.31 | $6.31 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $6.03 | Professional | None | $3.55 | $4.68 | $6.03 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | RR · Rental | $10.00 | $10.00 | $10.00 |
Where Michigan sits
The same service costs 2.7 times more in Hawaii than in Colorado. 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
$8.32
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.