How much rates vary
Facilitymedian $93 · 10th to 90th $52 to $219Professionalmedian $50 · 10th to 90th $31 to $78
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 $28.84 Median $50.12 Typical High $50.12 | Facility | None | $28.84 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $52.48 | Professional | None | $28.84 | $28.84 | $52.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $25.12 | Professional | 52 · Reduced service | $14.45 | $14.45 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $10.00 | Professional | 53 · Discontinued | $5.75 | $5.75 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $7.59 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Setting Facility Modifier None Typical Low $60.26 Median $147.91 Typical High $281.84 | Facility | None | $60.26 | $147.91 | $281.84 |
BCBS Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | None | $47.86 | $50.12 | $50.12 |
CareSource Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $83.18 | Professional | None | $44.67 | $52.48 | $83.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $35.48 Median $162.18 Typical High $177.83 | Facility | None | $35.48 | $162.18 | $177.83 |
Health Alliance Plan Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $79.43 | Professional | None | $35.48 | $60.26 | $79.43 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $5.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
Priority Health Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Priority Health Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $93.33 | Professional | None | $44.67 | $52.48 | $93.33 |
United Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $112.20 | Facility | None | $79.43 | $93.33 | $112.20 |
United Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $70.79 | Professional | None | $34.67 | $44.67 | $70.79 |
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 |
|---|---|---|---|---|---|
BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | RR · Rental | $50.12 | $50.12 | $50.12 |
Where Michigan sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 27th of 51
$50.12
HI $93.33UT $36.31
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.