How much rates vary
Facilitymedian $11 · 10th to 90th $4 to $30Professionalmedian $6 · 10th to 90th $3 to $7
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 $6.03 Median $6.03 Typical High $6.31 | Facility | None | $6.03 | $6.03 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | None | $6.03 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.02 Median $3.16 Typical High $3.16 | Professional | 52 · Reduced service | $3.02 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $1.20 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 55 · Aftercare only | $0.89 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.63 Typical High $0.63 | Professional | 56 · Pre-op care only | $0.60 | $0.63 | $0.63 |
Ambetter Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $7.94 Median $19.50 Typical High $37.15 | Facility | None | $7.94 | $19.50 | $37.15 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.31 Median $6.61 Typical High $6.61 | Professional | None | $6.31 | $6.61 | $6.61 |
CareSource Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.27 | Professional | None | $3.39 | $3.39 | $4.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.27 Median $5.13 Typical High $14.13 | Facility | None | $4.27 | $5.13 | $14.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $4.27 Median $5.25 Typical High $6.76 | Professional | None | $4.27 | $5.25 | $6.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $1.00 | $1.00 | $1.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
Priority Health Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Priority Health Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.01 | Professional | None | $3.39 | $3.39 | $5.01 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.09 Typical High $4.47 | Professional | None | $2.34 | $3.09 | $4.47 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | RR · Rental | $6.61 | $6.61 | $6.61 |
Where Michigan sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 14th of 51
$5.62
KS $7.08AL $3.39
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.