How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,023 to $12,023Professionalmedian $724 · 10th to 90th $316 to $3,467
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 $251.19 Median $4,073.80 Typical High $5,754.40 | Facility | None | $251.19 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $323.59 | Professional | None | $251.19 | $257.04 | $323.59 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,570.88 Median $5,754.40 Typical High $14,125.38 | Facility | None | $4,570.88 | $5,754.40 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $562.34 Median $3,467.37 Typical High $3,467.37 | Professional | None | $562.34 | $3,467.37 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $512.86 | Professional | None | $467.74 | $467.74 | $512.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $676.08 Median $1,862.09 Typical High $4,897.79 | Facility | None | $676.08 | $1,862.09 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $870.96 | Professional | None | $380.19 | $691.83 | $870.96 |
Priority Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $7,762.47 | Facility | None | $794.33 | $2,137.96 | $7,762.47 |
United Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $891.25 | Professional | None | $346.74 | $758.58 | $891.25 |
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 $125.89 Median $128.82 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $239.88 | Professional | 54 · Surgery only | $186.21 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $32.36 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where Michigan sits
The same service costs 7.8 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· 24th of 51
$759
TX $2,399DE $309
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.