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 $60.26 Median $60.26 Typical High $64.57 | Facility | None | $60.26 | $60.26 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $61.66 | Professional | None | $34.67 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $79.43 Median $190.55 Typical High $346.74 | Facility | None | $79.43 | $190.55 | $346.74 |
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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Facility | None | $44.67 | $44.67 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $57.54 | Professional | None | $38.02 | $38.02 | $57.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $52.48 Median $194.98 Typical High $213.80 | Facility | None | $52.48 | $194.98 | $213.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $97.72 | Professional | None | $52.48 | $72.44 | $97.72 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.94 |
Priority Health Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Facility | None | $44.67 | $44.67 | $54.95 |
Priority Health Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $74.13 | Professional | None | $38.02 | $44.67 | $74.13 |
United Setting Professional Modifier None Typical Low $26.92 Median $39.81 Typical High $61.66 | Professional | None | $26.92 | $39.81 | $61.66 |
6 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 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
Aetna Setting Professional Modifier MS · Maintenance fee Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | MS · Maintenance fee | $3.55 | $3.55 | $5.01 |
Aetna Setting Professional Modifier RR · Rental Typical Low $3.55 Median $3.55 Typical High $5.01 | Professional | RR · Rental | $3.55 | $3.55 | $5.01 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $5.75 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.89 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.47 | $3.89 | $5.01 |
Priority Health Setting Professional Modifier RR · Rental Typical Low $5.75 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $5.75 | $109.65 | $109.65 |
Where Michigan sits
The same service costs 2.5 times more in Wyoming than in Florida. 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
$61.66
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.