How much rates vary
Facilitymedian $309 · 10th to 90th $204 to $525Professionalmedian $204 · 10th to 90th $117 to $251
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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | None | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $36.31 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $20.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $363.08 | Professional | None | $109.65 | $109.65 | $363.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $204.17 Median $478.63 Typical High $524.81 | Facility | None | $204.17 | $478.63 | $524.81 |
Health Alliance Plan Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | None | $151.36 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $93.33 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $38.02 | $40.74 | $40.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $30.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.05 | $20.42 | $20.42 |
Priority Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $288.40 | Professional | None | $109.65 | $109.65 | $288.40 |
United Setting Facility Modifier None Typical Low $263.03 Median $309.03 Typical High $371.54 | Facility | None | $263.03 | $309.03 | $371.54 |
United Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $151.36 | Professional | None | $93.33 | $112.20 | $151.36 |
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 2.5 times more in Alaska than in Utah. 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· 12th of 51
$204
AK $269UT $110
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.