How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,202 to $11,482Professionalmedian $813 · 10th to 90th $631 to $5,129
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 $588.84 Median $4,073.80 Typical High $5,754.40 | Facility | None | $588.84 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $758.58 | Professional | None | $588.84 | $602.56 | $758.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,365.16 Median $5,623.41 Typical High $13,489.63 | Facility | None | $4,365.16 | $5,623.41 | $13,489.63 |
BCBS Michigan Setting Professional Modifier None Typical Low $870.96 Median $5,128.61 Typical High $5,495.41 | Professional | None | $870.96 | $5,128.61 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $3,235.94 | Professional | None | $933.25 | $1,047.13 | $3,235.94 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $4,897.79 | Facility | None | $1,584.89 | $2,511.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $870.96 | Professional | None | $630.96 | $776.25 | $870.96 |
Priority Health Setting Professional Modifier None Typical Low $933.25 Median $2,570.40 Typical High $3,235.94 | Professional | None | $933.25 | $2,570.40 | $3,235.94 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,454.71 Typical High $7,943.28 | Facility | None | $851.14 | $2,454.71 | $7,943.28 |
United Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,023.29 | Professional | None | $707.95 | $794.33 | $1,023.29 |
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 $295.12 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $295.12 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $120.23 Typical High $151.36 | Professional | 53 · Discontinued | $117.49 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $75.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Where Michigan sits
The same service costs 5.1 times more in Texas 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· 41st of 51
$851
TX $3,981DE $776
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.