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 $6.92 Median $6.92 Typical High $7.08 | Facility | None | $6.92 | $6.92 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $7.08 | Professional | None | $6.03 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.02 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.69 | $0.72 | $0.72 |
BCBS Michigan Setting Facility Modifier None Typical Low $9.12 Median $22.39 Typical High $42.66 | Facility | None | $9.12 | $22.39 | $42.66 |
BCBS Michigan Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | None | $7.24 | $7.59 | $7.59 |
CareSource Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $10.72 | Professional | None | $7.59 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $6.17 | Professional | None | $4.57 | $5.37 | $6.17 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.71 Median $5.89 Typical High $16.22 | Facility | None | $0.71 | $5.89 | $16.22 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $7.76 | Professional | None | $4.68 | $5.75 | $7.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $0.58 |
Priority Health Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Priority Health Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $6.92 | Professional | None | $4.57 | $5.37 | $6.92 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $5.37 | Professional | None | $3.16 | $3.80 | $5.37 |
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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | RR · Rental | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier U4 · State-defined Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | U4 · State-defined | $3.63 | $3.63 | $3.63 |
Health Alliance Plan Setting Professional Modifier U4 · State-defined Typical Low $2.88 Median $2.88 Typical High $3.63 | Professional | U4 · State-defined | $2.88 | $2.88 | $3.63 |
Priority Health Setting Professional Modifier U4 · State-defined Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | U4 · State-defined | $3.63 | $3.63 | $3.63 |
Where Michigan sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 17th of 51
$6.92
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.