How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $13Professionalmedian $2 · 10th to 90th $1 to $3
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 $2.57 Median $2.57 Typical High $2.69 | Facility | None | $2.57 | $2.57 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.69 Typical High $2.69 | Professional | None | $2.51 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 52 · Reduced service | $1.29 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.54 Typical High $0.54 | Professional | 53 · Discontinued | $0.52 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.39 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.26 | $0.27 | $0.27 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.95 | Professional | None | $2.34 | $2.34 | $2.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $3.47 Median $8.51 Typical High $16.22 | Facility | None | $3.47 | $8.51 | $16.22 |
BCBS Michigan Setting Professional Modifier None Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | None | $2.75 | $2.88 | $2.88 |
CareSource Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Facility | None | $1.86 | $1.86 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.04 | Professional | None | $1.23 | $1.23 | $2.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2.19 Median $5.62 Typical High $6.17 | Facility | None | $2.19 | $5.62 | $6.17 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1.82 Median $2.19 Typical High $2.95 | Professional | None | $1.82 | $2.19 | $2.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 52 · Reduced service | $1.10 | $1.10 | $1.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.44 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Priority Health Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Priority Health Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.14 | Professional | None | $1.23 | $1.23 | $2.14 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.35 Typical High $1.95 | Professional | None | $1.02 | $1.35 | $1.95 |
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 $2.88 Median $2.88 Typical High $2.88 | Professional | RR · Rental | $2.88 | $2.88 | $2.88 |
Where Michigan sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 15th of 51
$2.45
KS $3.31AL $1.48
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.