How much rates vary
Facilitymedian $562 · 10th to 90th $76 to $1,318Professionalmedian $63 · 10th to 90th $49 to $81
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 $58.88 Median $70.79 Typical High $2,041.74 | Facility | None | $58.88 | $70.79 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $77.62 | Professional | None | $52.48 | $63.10 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $67.61 | Professional | None | $42.66 | $42.66 | $67.61 |
BCBS Michigan Setting Facility Modifier None Typical Low $501.19 Median $562.34 Typical High $1,445.44 | Facility | None | $501.19 | $562.34 | $1,445.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $9.77 Median $52.48 Typical High $74.13 | Professional | None | $9.77 | $52.48 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $117.49 | Professional | None | $51.29 | $79.43 | $117.49 |
Health Alliance Plan Setting Facility Modifier None Typical Low $70.79 Median $446.68 Typical High $1,122.02 | Facility | None | $70.79 | $446.68 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $87.10 | Professional | None | $58.88 | $67.61 | $87.10 |
Priority Health Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $117.49 | Professional | None | $42.66 | $74.13 | $117.49 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $57.54 Median $69.18 Typical High $89.13 | Professional | None | $57.54 | $69.18 | $89.13 |
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 $28.18 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $14.45 | Professional | 53 · Discontinued | $11.22 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $44.67 Typical High $53.70 | Professional | 54 · Surgery only | $43.65 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $29.51 | $29.51 | $35.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $11.75 | $11.75 | $14.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | 54 · Surgery only | $44.67 | $44.67 | $52.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $10.47 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $10.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.08 |
Where Michigan sits
The same service costs 4.8 times more in Alaska 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· 30th of 51
$70.79
AK $240KY $50.12
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.