How much rates vary
Facilitymedian $31,623 · 10th to 90th $1,950 to $81,283Professionalmedian $1,660 · 10th to 90th $1,202 to $15,849
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 $1,071.52 Median $2,884.03 Typical High $4,897.79 | Facility | None | $1,071.52 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,096.48 | $1,380.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $31,622.78 Median $39,810.72 Typical High $97,723.72 | Facility | None | $31,622.78 | $39,810.72 | $97,723.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $3,162.28 Median $9,772.37 Typical High $15,848.93 | Professional | None | $3,162.28 | $9,772.37 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $23,442.29 | Professional | None | $1,698.24 | $1,905.46 | $23,442.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,884.03 Median $4,073.80 Typical High $10,000.00 | Facility | None | $2,884.03 | $4,073.80 | $10,000.00 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,479.11 | $1,778.28 |
Priority Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $23,442.29 | Professional | None | $1,698.24 | $2,630.27 | $23,442.29 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $5,754.40 Typical High $20,417.38 | Facility | None | $1,380.38 | $5,754.40 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,548.82 | $2,089.30 |
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 $537.03 Median $549.54 Typical High $691.83 | Professional | 52 · Reduced service | $537.03 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $275.42 | Professional | 53 · Discontinued | $213.80 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $138.04 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $138.04 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Where Michigan sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 33rd of 51
$1,778
AR $8,318KY $1,202
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.