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 $10.72 Median $10.72 Typical High $11.22 | Facility | None | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | None | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.37 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.14 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.62 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.07 | $1.12 | $1.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $14.45 Median $35.48 Typical High $66.07 | Facility | None | $14.45 | $35.48 | $66.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | None | $11.22 | $12.02 | $12.02 |
CareSource Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.59 | Professional | None | $6.03 | $6.03 | $7.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $8.51 Median $9.33 Typical High $25.12 | Facility | None | $8.51 | $9.33 | $25.12 |
Health Alliance Plan Setting Professional Modifier None Typical Low $7.59 Median $9.55 Typical High $12.02 | Professional | None | $7.59 | $9.55 | $12.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $4.57 | $4.57 | $4.57 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.82 | $1.82 | $1.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.35 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $0.91 |
Priority Health Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Priority Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $8.91 | Professional | None | $6.03 | $6.03 | $8.91 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.62 Typical High $7.94 | Professional | None | $4.17 | $5.62 | $7.94 |
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 $12.02 Median $12.02 Typical High $12.02 | Professional | RR · Rental | $12.02 | $12.02 | $12.02 |
Where Michigan sits
The same service costs 2.1 times more in Hawaii 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
$10.00
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.