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 $8.71 Median $2,041.74 Typical High $4,897.79 | Facility | None | $8.71 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | None | $8.71 | $9.12 | $9.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
BCBS Michigan Setting Professional Modifier None Typical Low $1.20 Median $6.61 Typical High $6.61 | Professional | None | $1.20 | $6.61 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $3.02 Typical High $11.75 | Professional | None | $1.26 | $3.02 | $11.75 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4.17 Median $8.32 Typical High $2,041.74 | Facility | None | $4.17 | $8.32 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2.82 Median $3.63 Typical High $9.33 | Professional | None | $2.82 | $3.63 | $9.33 |
Priority Health Setting Professional Modifier None Typical Low $1.26 Median $3.02 Typical High $9.33 | Professional | None | $1.26 | $3.02 | $9.33 |
United Setting Facility Modifier None Typical Low $5.62 Median $8.32 Typical High $11.22 | Facility | None | $5.62 | $8.32 | $11.22 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.82 Typical High $3.72 | Professional | None | $1.26 | $1.82 | $3.72 |
10 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 $3.55 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $3.55 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.41 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | 54 · Surgery only | $5.25 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.38 Typical High $1.38 | Professional | 55 · Aftercare only | $1.05 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.71 | $0.91 | $0.91 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 54 · Surgery only | $6.17 | $6.17 | $6.17 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Where Michigan sits
The same service costs 25.7 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· 32nd of 51
$5.13
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.