How much rates vary
Facilitymedian $129 · 10th to 90th $89 to $468Professionalmedian $85 · 10th to 90th $40 to $138
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 $53.70 Median $128.82 Typical High $4,897.79 | Facility | None | $53.70 | $128.82 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $138.04 | Professional | None | $53.70 | $79.43 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $89.13 | Professional | None | $38.02 | $38.02 | $89.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Facility | None | $114.82 | $114.82 | $199.53 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $138.04 | Professional | None | $26.30 | $44.67 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $123.03 | Professional | None | $35.48 | $74.13 | $123.03 |
Health Alliance Plan Setting Facility Modifier None Typical Low $50.12 Median $134.90 Typical High $371.54 | Facility | None | $50.12 | $134.90 | $371.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $53.70 Median $104.71 Typical High $138.04 | Professional | None | $53.70 | $104.71 | $138.04 |
Priority Health Setting Professional Modifier None Typical Low $35.48 Median $74.13 Typical High $123.03 | Professional | None | $35.48 | $74.13 | $123.03 |
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 $47.86 Median $85.11 Typical High $138.04 | Professional | None | $47.86 | $85.11 | $138.04 |
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 $26.30 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $26.30 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $10.72 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $72.44 Typical High $97.72 | Professional | 54 · Surgery only | $39.81 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.45 Typical High $19.50 | Professional | 55 · Aftercare only | $7.94 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $5.37 | $9.77 | $13.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $34.67 Typical High $66.07 | Professional | 52 · Reduced service | $26.92 | $34.67 | $66.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.13 Typical High $26.92 | Professional | 53 · Discontinued | $10.72 | $14.13 | $26.92 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $52.48 Typical High $100.00 | Professional | 54 · Surgery only | $40.74 | $52.48 | $100.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.47 Typical High $19.95 | Professional | 55 · Aftercare only | $8.13 | $10.47 | $19.95 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.92 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.37 | $6.92 | $13.49 |
Where Michigan sits
The same service costs 3.5 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· 41st of 51
$87.10
AK $229KY $66.07
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.