How much rates vary
Facilitymedian $195 · 10th to 90th $48 to $4,898Professionalmedian $54 · 10th to 90th $33 to $91
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 $53.70 Median $67.61 Typical High $6,918.31 | Facility | None | $53.70 | $67.61 | $6,918.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | None (both parts) | $53.70 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $20.42 Typical High $26.92 | Professional | 26 · Professional part | $20.42 | $20.42 | $26.92 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $33.11 Typical High $40.74 | Professional | TC · Technical part | $32.36 | $33.11 | $40.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $33.11 Median $35.48 Typical High $35.48 | Professional | None (both parts) | $33.11 | $35.48 | $35.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $70.79 Median $213.80 Typical High $4,897.79 | Facility | None | $70.79 | $213.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $70.79 Median $74.13 Typical High $97.72 | Professional | None (both parts) | $70.79 | $74.13 | $97.72 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $44.67 Typical High $58.88 | Professional | 26 · Professional part | $28.18 | $44.67 | $58.88 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $39.81 Typical High $42.66 | Professional | TC · Technical part | $28.84 | $39.81 | $42.66 |
United Setting Facility Modifier None Typical Low $38.02 Median $50.12 Typical High $104.71 | Facility | None | $38.02 | $50.12 | $104.71 |
United Setting Professional Modifier None (both parts) Typical Low $77.62 Median $87.10 Typical High $97.72 | Professional | None (both parts) | $77.62 | $87.10 | $97.72 |
United Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $52.48 Typical High $58.88 | Professional | 26 · Professional part | $30.20 | $52.48 | $58.88 |
United Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $34.67 Typical High $54.95 | Professional | TC · Technical part | $31.62 | $34.67 | $54.95 |
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 $26.30 Median $26.92 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $13.49 | Professional | 53 · Discontinued | $10.72 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $39.81 Typical High $51.29 | Professional | 54 · Surgery only | $39.81 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $6.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 54 · Surgery only | $53.70 | $53.70 | $53.70 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Where Michigan sits
The same service costs 4.4 times more in Texas than in New York. 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· 48th of 51
$53.70
TX $174NY $39.81
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.