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 $3.55 Median $3.55 Typical High $3.63 | Facility | None | $3.55 | $3.55 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $3.63 | Professional | None | $3.55 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.78 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.71 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.52 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.35 | $0.37 | $0.37 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.68 Median $11.48 Typical High $21.88 | Facility | None | $4.68 | $11.48 | $21.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | None | $3.72 | $3.89 | $3.89 |
CareSource Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.51 | Professional | None | $1.86 | $1.86 | $2.51 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.75 Median $3.09 Typical High $8.32 | Facility | None | $2.75 | $3.09 | $8.32 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.51 Median $3.09 Typical High $3.98 | Professional | None | $2.51 | $3.09 | $3.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Priority Health Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Priority Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.88 | Professional | None | $1.86 | $1.86 | $2.88 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.82 Typical High $2.57 | Professional | None | $1.38 | $1.82 | $2.57 |
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 $3.89 Median $3.89 Typical High $3.89 | Professional | RR · Rental | $3.89 | $3.89 | $3.89 |
Where Michigan sits
The same service costs 2.2 times more in Kansas than in Delaware. 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· 13th of 51
$3.31
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.