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 $275.42 Median $4,897.79 Typical High $6,918.31 | Facility | None | $275.42 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $389.05 | Professional | None | $275.42 | $281.84 | $389.05 |
BCBS Michigan Setting Facility Modifier None Typical Low $26,915.35 Median $30,199.52 Typical High $81,283.05 | Facility | None | $26,915.35 | $30,199.52 | $81,283.05 |
BCBS Michigan Setting Professional Modifier None Typical Low $3,630.78 Median $20,417.38 Typical High $21,379.62 | Professional | None | $3,630.78 | $20,417.38 | $21,379.62 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,754.23 Median $5,754.40 Typical High $15,848.93 | Facility | None | $2,754.23 | $5,754.40 | $15,848.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $389.05 Median $1,096.48 Typical High $1,548.82 | Professional | None | $389.05 | $1,096.48 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $10,000.00 Typical High $26,915.35 | Facility | None | $1,778.28 | $10,000.00 | $26,915.35 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,737.80 | Professional | None | $933.25 | $1,479.11 | $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 $138.04 Median $138.04 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $56.23 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $38.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $194.98 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $38.90 |
Where Michigan sits
The same service costs 50.1 times more in Arkansas 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· 22nd of 51
$2,042
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.