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 $10.00 Median $10.23 Typical High $12.59 | Facility | None | $10.00 | $10.23 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $38.02 | Professional | None | $10.00 | $10.00 | $38.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $21.88 Median $43.65 Typical High $91.20 | Facility | None | $21.88 | $43.65 | $91.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $29.51 | Professional | None | $20.89 | $21.88 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $10.23 Median $32.36 Typical High $100.00 | Facility | None | $10.23 | $32.36 | $100.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $10.00 Median $23.44 Typical High $35.48 | Professional | None | $10.00 | $23.44 | $35.48 |
Priority Health Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | None | $17.78 | $20.89 | $20.89 |
United Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $131.83 | Facility | None | $47.86 | $63.10 | $131.83 |
United Setting Professional Modifier None Typical Low $13.80 Median $23.44 Typical High $33.88 | Professional | None | $13.80 | $23.44 | $33.88 |
4 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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Michigan sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 30th of 51
$23.44
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.