How much rates vary
Facilitymedian $282 · 10th to 90th $100 to $661Professionalmedian $132 · 10th to 90th $66 to $182
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 $85.11 Median $173.78 Typical High $4,897.79 | Facility | None | $85.11 | $173.78 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $181.97 | Professional | None | $85.11 | $123.03 | $181.97 |
BCBS Michigan Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $489.78 | Facility | None | $281.84 | $281.84 | $489.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $181.97 | Professional | None | $46.77 | $70.79 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $162.18 | Professional | None | $56.23 | $102.33 | $162.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $83.18 Median $346.74 Typical High $4,897.79 | Facility | None | $83.18 | $346.74 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $181.97 | Professional | None | $83.18 | $151.36 | $181.97 |
Priority Health Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $162.18 | Professional | None | $56.23 | $97.72 | $162.18 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $190.55 | Professional | None | $79.43 | $128.82 | $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 $42.66 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $42.66 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $16.98 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $63.10 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $26.30 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.51 | $12.88 | $17.38 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $54.95 Typical High $87.10 | Professional | 52 · Reduced service | $41.69 | $54.95 | $87.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $34.67 | Professional | 53 · Discontinued | $16.60 | $21.88 | $34.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $81.28 Typical High $131.83 | Professional | 54 · Surgery only | $63.10 | $81.28 | $131.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $26.30 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $26.30 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $17.38 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 31st of 51
$132
AK $355MD $100
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.