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 $58.88 Median $58.88 Typical High $61.66 | Facility | None | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $79.43 Median $194.98 Typical High $371.54 | Facility | None | $79.43 | $194.98 | $371.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | None | $63.10 | $66.07 | $66.07 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $41.69 Typical High $46.77 | Professional | None | $33.88 | $41.69 | $46.77 |
Health Alliance Plan Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $141.25 | Facility | None | $50.12 | $128.82 | $141.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $67.61 | Professional | None | $41.69 | $50.12 | $67.61 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Priority Health Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Priority Health Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $48.98 | Professional | None | $39.81 | $41.69 | $48.98 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $46.77 | Professional | None | $23.44 | $30.90 | $46.77 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | RR · Rental | $66.07 | $66.07 | $66.07 |
Where Michigan sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 16th of 51
$54.95
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.