How much rates vary
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 $54.95 Median $57.54 Typical High $169.82 | Facility | None | $54.95 | $57.54 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $79.43 | Professional | None | $52.48 | $54.95 | $79.43 |
BCBS Michigan Setting Facility Modifier None Typical Low $63.10 Median $134.90 Typical High $245.47 | Facility | None | $63.10 | $134.90 | $245.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | None | $51.29 | $53.70 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | None | $46.77 | $46.77 | $47.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $53.70 Median $79.43 Typical High $169.82 | Facility | None | $53.70 | $79.43 | $169.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $72.44 | Professional | None | $52.48 | $54.95 | $72.44 |
Priority Health Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | None | $46.77 | $46.77 | $47.86 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
4 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.50 |
Where Michigan sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 21st of 51
$54.95
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.