How much rates vary
Facilitymedian $51 · 10th to 90th $30 to $200Professionalmedian $37 · 10th to 90th $25 to $52
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 $28.84 Median $29.51 Typical High $51.29 | Facility | None | $28.84 | $29.51 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $54.95 | Professional | None | $28.84 | $28.84 | $54.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $25.70 | Professional | 52 · Reduced service | $14.45 | $14.45 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $10.23 | Professional | 53 · Discontinued | $5.89 | $5.89 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $7.59 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $5.13 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $61.66 Median $151.36 Typical High $288.40 | Facility | None | $61.66 | $151.36 | $288.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | None | $48.98 | $51.29 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $74.13 | Professional | None | $52.48 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $53.70 | Professional | None | $25.70 | $34.67 | $53.70 |
Health Alliance Plan Setting Facility Modifier None Typical Low $29.51 Median $38.02 Typical High $109.65 | Facility | None | $29.51 | $38.02 | $109.65 |
Health Alliance Plan Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $52.48 | Professional | None | $29.51 | $38.90 | $52.48 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Priority Health Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Priority Health Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $48.98 | Professional | None | $25.70 | $34.67 | $48.98 |
United Setting Facility Modifier None Typical Low $16.22 Median $31.62 Typical High $60.26 | Facility | None | $16.22 | $31.62 | $60.26 |
United Setting Professional Modifier None Typical Low $18.20 Median $24.55 Typical High $33.88 | Professional | None | $18.20 | $24.55 | $33.88 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | KX · Policy requirements met | $37.15 | $37.15 | $37.15 |
BCBS Michigan Setting Professional Modifier RR · Rental Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | RR · Rental | $51.29 | $51.29 | $51.29 |
Where Michigan sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 20th of 51
$37.15
HI $77.62DC $24.55
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.