How much rates vary
Facilitymedian $316 · 10th to 90th $148 to $912Professionalmedian $166 · 10th to 90th $98 to $214
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 $120.23 Median $208.93 Typical High $208.93 | Facility | None | $120.23 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $208.93 | Professional | None | $120.23 | $120.23 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $104.71 | Professional | 52 · Reduced service | $60.26 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $41.69 | Professional | 53 · Discontinued | $23.99 | $23.99 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $31.62 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $20.89 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $20.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $616.60 Typical High $1,174.90 | Facility | None | $251.19 | $616.60 | $1,174.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | None | $199.53 | $208.93 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $234.42 | Professional | None | $107.15 | $147.91 | $234.42 |
Health Alliance Plan Setting Facility Modifier None Typical Low $120.23 Median $407.38 Typical High $446.68 | Facility | None | $120.23 | $407.38 | $446.68 |
Health Alliance Plan Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $213.80 | Professional | None | $120.23 | $165.96 | $213.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Priority Health Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Priority Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $208.93 | Professional | None | $107.15 | $147.91 | $208.93 |
United Setting Facility Modifier None Typical Low $102.33 Median $218.78 Typical High $257.04 | Facility | None | $102.33 | $218.78 | $257.04 |
United Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $144.54 | Professional | None | $77.62 | $97.72 | $144.54 |
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 Michigan Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | RR · Rental | $208.93 | $208.93 | $208.93 |
Where Michigan sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 16th of 51
$166
KS $575WV $107
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.