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 $77.62 Median $79.43 Typical High $89.13 | Facility | None | $77.62 | $79.43 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $93.33 | Professional | None | $77.62 | $87.10 | $93.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $323.59 | Facility | None | $125.89 | $186.21 | $323.59 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | None | $117.49 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $199.53 | Professional | None | $83.18 | $199.53 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $38.90 Median $95.50 Typical High $281.84 | Facility | None | $38.90 | $95.50 | $281.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $134.90 | Professional | None | $72.44 | $97.72 | $134.90 |
Priority Health Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $199.53 | Professional | None | $83.18 | $199.53 | $199.53 |
United Setting Professional Modifier None Typical Low $24.55 Median $57.54 Typical High $107.15 | Professional | None | $24.55 | $57.54 | $107.15 |
8 more rates 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $46.77 | Professional | 52 · Reduced service | $38.90 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $18.62 | Professional | 53 · Discontinued | $15.49 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $9.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $36.31 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where Michigan sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 6th of 51
$112
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.