How much rates vary
Facilitymedian $91 · 10th to 90th $69 to $479Professionalmedian $20 · 10th to 90th $15 to $25
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 $19.05 Median $21.38 Typical High $4,897.79 | Facility | None | $19.05 | $21.38 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $22.39 | Professional | None | $16.98 | $19.95 | $22.39 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
BCBS Michigan Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $123.03 | Facility | None | $69.18 | $70.79 | $123.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $3.55 Median $15.49 Typical High $22.39 | Professional | None | $3.55 | $15.49 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $17.38 Typical High $22.91 | Professional | None | $12.30 | $17.38 | $22.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $20.42 Median $54.95 Typical High $4,897.79 | Facility | None | $20.42 | $54.95 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $25.12 | Professional | None | $19.05 | $21.88 | $25.12 |
Priority Health Setting Professional Modifier None Typical Low $12.30 Median $16.98 Typical High $22.39 | Professional | None | $12.30 | $16.98 | $22.39 |
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 $17.38 Median $20.42 Typical High $25.12 | Professional | None | $17.38 | $20.42 | $25.12 |
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 $9.55 Median $9.55 Typical High $10.96 | Professional | 52 · Reduced service | $9.55 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.37 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $14.45 Typical High $16.22 | Professional | 54 · Surgery only | $14.13 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.88 Typical High $3.24 | Professional | 55 · Aftercare only | $2.82 | $2.88 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.19 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $9.77 Typical High $10.96 | Professional | 52 · Reduced service | $9.77 | $9.77 | $10.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $4.37 | Professional | 53 · Discontinued | $3.89 | $3.89 | $4.37 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 54 · Surgery only | $14.45 | $14.45 | $16.22 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $3.24 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $3.24 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.19 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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
$20.42
AK $64.57NJ $16.60
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.