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 $4.68 Median $4.68 Typical High $4.90 | Facility | None | $4.68 | $4.68 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $4.90 | Professional | None | $4.68 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.34 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.34 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $0.95 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.74 Typical High $0.74 | Professional | 55 · Aftercare only | $0.71 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.47 | $0.49 | $0.49 |
BCBS Michigan Setting Facility Modifier None Typical Low $6.31 Median $15.49 Typical High $29.51 | Facility | None | $6.31 | $15.49 | $29.51 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.01 Median $5.25 Typical High $5.25 | Professional | None | $5.01 | $5.25 | $5.25 |
CareSource Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.55 | Professional | None | $2.63 | $2.63 | $3.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.07 Median $9.55 Typical High $11.22 | Facility | None | $4.07 | $9.55 | $11.22 |
Health Alliance Plan Setting Professional Modifier None Typical Low $3.55 Median $4.17 Typical High $5.37 | Professional | None | $3.55 | $4.17 | $5.37 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.79 | $0.79 | $0.79 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Priority Health Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Priority Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.80 | Professional | None | $2.63 | $2.63 | $3.80 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.45 Typical High $3.47 | Professional | None | $1.86 | $2.45 | $3.47 |
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 $5.25 Median $5.25 Typical High $5.25 | Professional | RR · Rental | $5.25 | $5.25 | $5.25 |
Where Michigan sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 12th of 51
$4.57
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.