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 $3.39 Median $3.39 Typical High $3.55 | Facility | None | $3.39 | $3.39 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $3.55 | Professional | None | $3.39 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.70 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.68 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.51 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.34 | $0.36 | $0.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $4.57 Median $11.22 Typical High $20.89 | Facility | None | $4.57 | $11.22 | $20.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.63 Median $3.80 Typical High $3.80 | Professional | None | $3.63 | $3.80 | $3.80 |
CareSource Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.09 | Professional | None | $1.78 | $1.78 | $3.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.88 Median $7.41 Typical High $8.13 | Facility | None | $2.88 | $7.41 | $8.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.63 Median $3.02 Typical High $3.89 | Professional | None | $2.63 | $3.02 | $3.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.43 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Priority Health Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Priority Health Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $3.16 | Professional | None | $1.78 | $1.78 | $3.16 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.91 Typical High $2.69 | Professional | None | $1.58 | $1.91 | $2.69 |
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 $3.80 Median $3.80 Typical High $3.80 | Professional | RR · Rental | $3.80 | $3.80 | $3.80 |
Where Michigan sits
The same service costs 2.1 times more in Montana 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· 14th of 51
$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.