How much rates vary
Facilitymedian $219 · 10th to 90th $132 to $977Professionalmedian $132 · 10th to 90th $52 to $195
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 $67.61 Median $173.78 Typical High $4,897.79 | Facility | None | $67.61 | $173.78 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $186.21 | Professional | None | $67.61 | $131.83 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
BCBS Setting Facility Modifier None Typical Low $147.91 Median $165.96 Typical High $446.68 | Facility | None | $147.91 | $165.96 | $446.68 |
BCBS Setting Professional Modifier None Typical Low $10.72 Median $56.23 Typical High $186.21 | Professional | None | $10.72 | $56.23 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $173.78 | Professional | None | $45.71 | $100.00 | $173.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $69.18 Median $186.21 Typical High $4,897.79 | Facility | None | $69.18 | $186.21 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $199.53 | Professional | None | $66.07 | $173.78 | $199.53 |
Priority Health Setting Professional Modifier None Typical Low $45.71 Median $100.00 Typical High $169.82 | Professional | None | $45.71 | $100.00 | $169.82 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $190.55 | Professional | None | $67.61 | $131.83 | $190.55 |
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 $33.88 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $33.88 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $13.49 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $50.12 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $10.00 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.76 | $12.88 | $17.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $43.65 Typical High $89.13 | Professional | 52 · Reduced service | $33.11 | $43.65 | $89.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $35.48 | Professional | 53 · Discontinued | $13.18 | $17.38 | $35.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $66.07 Typical High $134.90 | Professional | 54 · Surgery only | $50.12 | $66.07 | $134.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $26.92 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.71 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.61 | $8.71 | $17.78 |
Where Michigan sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 27th of 51
$148
AK $282MT $107
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.