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 $4.47 Median $4.47 Typical High $4.68 | Facility | None | $4.47 | $4.47 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | None | $4.47 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $2.24 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.89 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.68 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.45 | $0.47 | $0.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.03 Median $14.79 Typical High $28.18 | Facility | None | $6.03 | $14.79 | $28.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.79 Median $5.01 Typical High $5.01 | Professional | None | $4.79 | $5.01 | $5.01 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.24 | Professional | None | $2.51 | $2.51 | $3.24 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.47 Median $3.89 Typical High $10.72 | Facility | None | $3.47 | $3.89 | $10.72 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.16 Median $3.89 Typical High $5.13 | Professional | None | $3.16 | $3.89 | $5.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 52 · Reduced service | $1.91 | $1.91 | $1.91 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.76 | $0.76 | $0.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.38 |
Priority Health Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Priority Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.80 | Professional | None | $2.51 | $2.51 | $3.80 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.34 Typical High $3.31 | Professional | None | $1.78 | $2.34 | $3.31 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | RR · Rental | $5.01 | $5.01 | $5.01 |
Where Michigan sits
The same service costs 2.3 times more in Kansas than in Utah. 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
$4.27
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.