How much rates vary
Facilitymedian $204 · 10th to 90th $126 to $324Professionalmedian $126 · 10th to 90th $74 to $158
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $125.89 | Professional | None | $112.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $12.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | None | $147.91 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $229.09 | Professional | None | $72.44 | $72.44 | $229.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $125.89 Median $302.00 Typical High $323.59 | Facility | None | $125.89 | $302.00 | $323.59 |
Health Alliance Plan Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $128.82 | Professional | None | $93.33 | $125.89 | $128.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $60.26 | $63.10 | $63.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $23.99 | $25.12 | $25.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $19.05 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $12.59 |
Priority Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $181.97 | Professional | None | $72.44 | $72.44 | $181.97 |
United Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $239.88 | Facility | None | $169.82 | $204.17 | $239.88 |
United Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $93.33 | Professional | None | $61.66 | $72.44 | $93.33 |
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 |
|---|---|---|---|---|---|
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Michigan sits
The same service costs 2.6 times more in Montana than in Ohio. 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· 19th of 51
$126
MT $186OH $72.44
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.