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 $23.44 Median $85.11 Typical High $4,897.79 | Facility | None | $23.44 | $85.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $56.23 Typical High $87.10 | Professional | None | $22.39 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $28.18 Typical High $42.66 | Professional | 52 · Reduced service | $11.22 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $11.48 Typical High $17.38 | Professional | 53 · Discontinued | $4.57 | $11.48 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $8.51 Typical High $12.88 | Professional | 55 · Aftercare only | $3.39 | $8.51 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $5.62 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.24 | $5.62 | $8.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $194.98 Median $269.15 Typical High $575.44 | Facility | None | $194.98 | $269.15 | $575.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.89 Median $18.20 Typical High $29.51 | Professional | None | $5.89 | $18.20 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $95.50 | Professional | None | $38.90 | $74.13 | $95.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $23.44 Median $169.82 Typical High $4,897.79 | Facility | None | $23.44 | $169.82 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $23.44 Median $79.43 Typical High $89.13 | Professional | None | $23.44 | $79.43 | $89.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $20.42 Typical High $43.65 | Professional | 52 · Reduced service | $11.75 | $20.42 | $43.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $8.32 Typical High $17.38 | Professional | 53 · Discontinued | $4.68 | $8.32 | $17.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $6.17 Typical High $12.88 | Professional | 55 · Aftercare only | $3.55 | $6.17 | $12.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.17 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.34 | $4.17 | $8.71 |
Priority Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | None | $74.13 | $74.13 | $95.50 |
United Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $562.34 | Facility | None | $204.17 | $269.15 | $562.34 |
United Setting Professional Modifier None Typical Low $26.92 Median $42.66 Typical High $89.13 | Professional | None | $26.92 | $42.66 | $89.13 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 59 · Distinct service | $50.12 | $50.12 | $50.12 |
Where Michigan sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 49th of 51
$29.51
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.