How much rates vary
Facilitymedian $9 · 10th to 90th $3 to $21Professionalmedian $4 · 10th to 90th $2 to $5
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 $4.27 Median $4.27 Typical High $4.47 | Facility | None | $4.27 | $4.27 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.47 Typical High $4.47 | Professional | None | $4.07 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.14 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.85 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.65 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.43 | $0.45 | $0.45 |
Ambetter Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $4.79 | Professional | None | $3.89 | $3.89 | $4.79 |
BCBS Michigan Setting Facility Modifier None Typical Low $5.75 Median $14.13 Typical High $26.30 | Facility | None | $5.75 | $14.13 | $26.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | None | $4.47 | $4.79 | $4.79 |
CareSource Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.02 | Professional | None | $2.34 | $2.34 | $3.02 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3.63 Median $9.12 Typical High $10.00 | Facility | None | $3.63 | $9.12 | $10.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.95 Median $3.63 Typical High $4.79 | Professional | None | $2.95 | $3.63 | $4.79 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.72 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Priority Health Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Priority Health Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.55 | Professional | None | $2.34 | $2.34 | $3.55 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.24 Typical High $3.16 | Professional | None | $1.70 | $2.24 | $3.16 |
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 $4.79 Median $4.79 Typical High $4.79 | Professional | RR · Rental | $4.79 | $4.79 | $4.79 |
Where Michigan sits
The same service costs 2.2 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
$3.98
KS $5.25NJ $2.40
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.