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 $1.58 Median $1.58 Typical High $1.62 | Facility | None | $1.58 | $1.58 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.66 Typical High $1.66 | Professional | None | $1.58 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.79 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.79 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.32 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $2.09 Median $5.01 Typical High $9.33 | Facility | None | $2.09 | $5.01 | $9.33 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.66 Median $1.74 Typical High $1.74 | Professional | None | $1.66 | $1.74 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.89 | Professional | None | $0.56 | $0.56 | $0.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1.35 Median $3.47 Typical High $3.80 | Facility | None | $1.35 | $3.47 | $3.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.29 Median $1.35 Typical High $1.74 | Professional | None | $1.29 | $1.35 | $1.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Priority Health Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.89 | Professional | None | $0.56 | $0.56 | $0.89 |
United Setting Professional Modifier None Typical Low $0.63 Median $0.83 Typical High $1.07 | Professional | None | $0.63 | $0.83 | $1.07 |
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 $1.74 Median $1.74 Typical High $1.74 | Professional | RR · Rental | $1.74 | $1.74 | $1.74 |
Where Michigan sits
The same service costs 2.5 times more in Idaho than in Colorado. 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
$1.51
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.