How much rates vary
Facilitymedian $813 · 10th to 90th $302 to $2,291Professionalmedian $398 · 10th to 90th $263 to $537
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 $302.00 Median $302.00 Typical High $524.81 | Facility | None | $302.00 | $302.00 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $537.03 | Professional | None | $302.00 | $302.00 | $537.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $263.03 | Professional | 52 · Reduced service | $151.36 | $151.36 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $104.71 | Professional | 53 · Discontinued | $60.26 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $52.48 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $2,951.21 | Facility | None | $630.96 | $1,548.82 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | None | $501.19 | $524.81 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $616.60 | Professional | None | $239.88 | $331.13 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $302.00 Median $1,023.29 Typical High $1,122.02 | Facility | None | $302.00 | $1,023.29 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $537.03 | Professional | None | $302.00 | $416.87 | $537.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $60.26 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $44.67 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $30.20 |
Priority Health Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Priority Health Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $588.84 | Professional | None | $239.88 | $331.13 | $588.84 |
United Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $724.44 | Facility | None | $218.78 | $263.03 | $724.44 |
United Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $398.11 | Professional | None | $218.78 | $263.03 | $398.11 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | RR · Rental | $524.81 | $524.81 | $524.81 |
Where Michigan sits
The same service costs 2.4 times more in Arkansas 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· 18th of 51
$407
AR $603FL $251
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.