How much rates vary
Facilitymedian $83 · 10th to 90th $46 to $295Professionalmedian $58 · 10th to 90th $38 to $81
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 $46.77 Median $58.88 Typical High $81.28 | Facility | None | $46.77 | $58.88 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $83.18 | Professional | None | $43.65 | $46.77 | $83.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | 52 · Reduced service | $23.44 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $16.22 | Professional | 53 · Discontinued | $9.33 | $9.33 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $12.02 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | None | $61.66 | $81.28 | $81.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $97.72 Median $239.88 Typical High $446.68 | Facility | None | $97.72 | $239.88 | $446.68 |
BCBS Michigan Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | None | $75.86 | $81.28 | $81.28 |
CareSource Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $93.33 | Professional | None | $66.07 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $81.28 | Professional | None | $33.11 | $45.71 | $81.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $45.71 Median $81.28 Typical High $169.82 | Facility | None | $45.71 | $81.28 | $169.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $89.13 | Professional | None | $45.71 | $57.54 | $89.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $22.91 | $22.91 | $22.91 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $6.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $4.57 |
Priority Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Priority Health Setting Professional Modifier None Typical Low $33.11 Median $45.71 Typical High $74.13 | Professional | None | $33.11 | $45.71 | $74.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $89.13 | Facility | None | $43.65 | $52.48 | $89.13 |
United Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $53.70 | Professional | None | $27.54 | $38.02 | $53.70 |
2 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | RR · Rental | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier KX · Policy requirements met Typical Low $52.48 Median $56.23 Typical High $363.08 | Professional | KX · Policy requirements met | $52.48 | $56.23 | $363.08 |
Where Michigan sits
The same service costs 3.8 times more in Hawaii than in Florida. 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
$58.88
HI $126FL $33.11
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.