How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | None | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $45.71 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $10.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $151.36 | Facility | None | $97.72 | $151.36 | $151.36 |
BCBS Michigan Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $162.18 | Professional | None | $144.54 | $151.36 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $141.25 | Professional | None | $89.13 | $120.23 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | None | $83.18 | $83.18 | $109.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $91.20 Median $95.50 Typical High $95.50 | Facility | None | $91.20 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | None | $95.50 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $46.77 | $50.12 | $50.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.05 | $19.95 | $19.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $14.13 | $15.14 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $10.00 |
Priority Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $107.15 | Facility | None | $77.62 | $97.72 | $107.15 |
United Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $104.71 | Professional | None | $89.13 | $97.72 | $104.71 |
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 CG · Policy criteria applied Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | CG · Policy criteria applied | $77.62 | $77.62 | $77.62 |
Where Michigan sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 21st of 51
$100
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.