How much rates vary
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 $891.25 Median $1,122.02 Typical High $6,918.31 | Facility | None | $891.25 | $1,122.02 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $1,122.02 Median $6,918.31 Typical High $6,918.31 | Professional | None | $1,122.02 | $6,918.31 | $6,918.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $4,897.79 | Facility | None | $3,235.94 | $3,890.45 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,380.38 | $1,737.80 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,548.82 | $1,737.80 |
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 $436.52 Median $446.68 Typical High $562.34 | Professional | 52 · Reduced service | $436.52 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $169.82 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $112.20 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $870.96 | $870.96 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Where Michigan sits
The same service costs 5.9 times more in Texas 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· 37th of 51
$1,549
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.