How much rates vary
Facilitymedian $1,778 · 10th to 90th $490 to $5,370Professionalmedian $417 · 10th to 90th $186 to $3,090
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 $316.23 Median $2,884.03 Typical High $4,897.79 | Facility | None | $316.23 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $407.38 | Professional | None | $316.23 | $323.59 | $407.38 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $724.44 Median $1,949.84 Typical High $3,090.30 | Professional | None | $724.44 | $1,949.84 | $3,090.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $416.87 Median $1,778.28 Typical High $4,897.79 | Facility | None | $416.87 | $1,778.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $346.74 | Professional | None | $165.96 | $213.80 | $346.74 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $512.86 | Professional | None | $389.05 | $467.74 | $512.86 |
11 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 $158.49 Median $162.18 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $39.81 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | 50 · Both sides | $5,011.87 | $5,011.87 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $173.78 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Where Michigan sits
The same service costs 28.2 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· 29th of 51
$437
TX $2,570KY $91.20
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.