How much rates vary
Facilitymedian $204 · 10th to 90th $91 to $603Professionalmedian $112 · 10th to 90th $69 to $141
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 $81.28 Median $138.04 Typical High $138.04 | Facility | None | $81.28 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $138.04 | Professional | None | $81.28 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $69.18 | Professional | 52 · Reduced service | $40.74 | $40.74 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $28.18 | Professional | 53 · Discontinued | $16.22 | $16.22 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $20.89 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $13.80 |
BCBS Michigan Setting Facility Modifier None Typical Low $169.82 Median $416.87 Typical High $776.25 | Facility | None | $169.82 | $416.87 | $776.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | None | $131.83 | $138.04 | $138.04 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $162.18 | Professional | None | $66.07 | $91.20 | $162.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $79.43 Median $275.42 Typical High $295.12 | Facility | None | $79.43 | $275.42 | $295.12 |
Health Alliance Plan Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $141.25 | Professional | None | $79.43 | $112.20 | $141.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Priority Health Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Priority Health Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $154.88 | Professional | None | $66.07 | $91.20 | $154.88 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $190.55 | Facility | None | $39.81 | $69.18 | $190.55 |
United Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $97.72 | Professional | None | $57.54 | $69.18 | $97.72 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | RR · Rental | $138.04 | $138.04 | $138.04 |
Where Michigan sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 14th of 51
$112
MT $162DE $66.07
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.