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 $69.18 Median $194.98 Typical High $218.78 | Facility | None | $69.18 | $194.98 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $134.90 | Professional | None | $67.61 | $69.18 | $134.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $67.61 Median $83.18 Typical High $239.88 | Facility | None | $67.61 | $83.18 | $239.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $72.44 | Professional | None | $63.10 | $66.07 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $109.65 | Professional | None | $67.61 | $109.65 | $109.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $218.78 | Facility | None | $114.82 | $181.97 | $218.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $104.71 | Professional | None | $67.61 | $70.79 | $104.71 |
Priority Health Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $109.65 | Professional | None | $67.61 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | None | $67.61 | $67.61 | $91.20 |
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 $33.11 Median $34.67 Typical High $109.65 | Professional | 52 · Reduced service | $33.11 | $34.67 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.80 Typical High $43.65 | Professional | 53 · Discontinued | $13.49 | $13.80 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $32.36 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.92 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.76 | $6.92 | $21.88 |
Where Michigan sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 33rd of 51
$69.18
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.