How much rates vary
Facilitymedian $44 · 10th to 90th $16 to $123Professionalmedian $22 · 10th to 90th $13 to $29
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 $16.60 Median $28.18 Typical High $28.18 | Facility | None | $16.60 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $28.18 | Professional | None | $16.60 | $16.60 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $14.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $5.62 | Professional | 53 · Discontinued | $3.31 | $3.31 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $4.27 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $33.88 Median $83.18 Typical High $158.49 | Facility | None | $33.88 | $83.18 | $158.49 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | None | $26.92 | $28.18 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $30.90 | Professional | None | $11.48 | $15.85 | $30.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $16.22 Median $54.95 Typical High $60.26 | Facility | None | $16.22 | $54.95 | $60.26 |
Health Alliance Plan Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $28.84 | Professional | None | $16.22 | $22.39 | $28.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Priority Health Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Priority Health Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $28.18 | Professional | None | $11.48 | $15.85 | $28.18 |
United Setting Facility Modifier None Typical Low $13.49 Median $29.51 Typical High $34.67 | Facility | None | $13.49 | $29.51 | $34.67 |
United Setting Professional Modifier None Typical Low $10.47 Median $13.18 Typical High $19.50 | Professional | None | $10.47 | $13.18 | $19.50 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | RR · Rental | $28.18 | $28.18 | $28.18 |
Where Michigan sits
The same service costs 5.5 times more in Kansas 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· 16th of 51
$22.39
KS $63.10DE $11.48
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.