How much rates vary
Facilitymedian $120 · 10th to 90th $91 to $447Professionalmedian $105 · 10th to 90th $54 to $162
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 $74.13 Median $154.88 Typical High $4,897.79 | Facility | None | $74.13 | $154.88 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $162.18 | Professional | None | $74.13 | $100.00 | $162.18 |
BCBS Michigan Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $165.96 | Facility | None | $95.50 | $95.50 | $165.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.59 Median $61.66 Typical High $162.18 | Professional | None | $12.59 | $61.66 | $162.18 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $144.54 | Professional | None | $50.12 | $91.20 | $144.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $50.12 Median $123.03 Typical High $3,715.35 | Facility | None | $50.12 | $123.03 | $3,715.35 |
Health Alliance Plan Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $162.18 | Professional | None | $74.13 | $123.03 | $162.18 |
Priority Health Setting Professional Modifier None Typical Low $50.12 Median $91.20 Typical High $144.54 | Professional | None | $50.12 | $91.20 | $144.54 |
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 $67.61 Median $107.15 Typical High $154.88 | Professional | None | $67.61 | $107.15 | $154.88 |
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 $37.15 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $37.15 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.91 Typical High $31.62 | Professional | 53 · Discontinued | $14.79 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $85.11 Typical High $117.49 | Professional | 54 · Surgery only | $56.23 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $11.22 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.41 | $11.48 | $15.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $47.86 Typical High $79.43 | Professional | 52 · Reduced service | $37.15 | $47.86 | $79.43 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.05 Typical High $31.62 | Professional | 53 · Discontinued | $14.79 | $19.05 | $31.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $72.44 Typical High $117.49 | Professional | 54 · Surgery only | $54.95 | $72.44 | $117.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $23.44 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $23.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $15.85 |
Where Michigan sits
The same service costs 3.2 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· 40th of 51
$107
AK $275KY $85.11
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.