How much rates vary
Facilitymedian $245 · 10th to 90th $126 to $891Professionalmedian $117 · 10th to 90th $81 to $204
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 $117.49 Median $204.17 Typical High $204.17 | Facility | None | $117.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $204.17 | Professional | None | $112.20 | $117.49 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $100.00 | Professional | 52 · Reduced service | $58.88 | $58.88 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $40.74 | Professional | 53 · Discontinued | $23.44 | $23.44 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $30.20 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $154.88 | Professional | None | $114.82 | $114.82 | $154.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $245.47 Median $602.56 Typical High $1,122.02 | Facility | None | $245.47 | $602.56 | $1,122.02 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | None | $190.55 | $204.17 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $288.40 | Professional | None | $204.17 | $281.84 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $223.87 | Professional | None | $93.33 | $125.89 | $223.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $208.93 | Facility | None | $114.82 | $190.55 | $208.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $204.17 | Professional | None | $70.79 | $114.82 | $204.17 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $57.54 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Priority Health Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Priority Health Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $199.53 | Professional | None | $93.33 | $125.89 | $199.53 |
United Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $295.12 | Facility | None | $208.93 | $245.47 | $295.12 |
United Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $151.36 | Professional | None | $74.13 | $97.72 | $151.36 |
3 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 $204.17 Median $204.17 Typical High $204.17 | Professional | RR · Rental | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | RR · Rental | $10.72 | $12.59 | $12.59 |
Priority Health Setting Professional Modifier RR · Rental Typical Low $10.72 Median $12.59 Typical High $12.59 | Professional | RR · Rental | $10.72 | $12.59 | $12.59 |
Where Michigan sits
The same service costs 2.1 times more in Hawaii 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· 36th of 51
$117
HI $200DE $93.33
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.