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 Professional Modifier None Typical Low $0.72 Median $0.76 Typical High $0.76 | Professional | None | $0.72 | $0.76 | $0.76 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Health Alliance Plan Setting Facility Modifier None Typical Low $0.79 Median $2.19 Typical High $2.63 | Facility | None | $0.79 | $2.19 | $2.63 |
Health Alliance Plan Setting Professional Modifier None Typical Low $0.71 Median $0.89 Typical High $1.20 | Professional | None | $0.71 | $0.89 | $1.20 |
Priority Health Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.89 Typical High $0.93 | Professional | None | $0.36 | $0.89 | $0.93 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $0.07 | $7.76 | $8.71 |
Where Michigan sits
The same service costs 3.1 times more in Kansas than in Oklahoma. 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· 11th of 51
$0.89
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.