How much rates vary
Facilitymedian $166 · 10th to 90th $91 to $550Professionalmedian $123 · 10th to 90th $66 to $186
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 $89.13 Median $177.83 Typical High $4,897.79 | Facility | None | $89.13 | $177.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $186.21 | Professional | None | $89.13 | $114.82 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $263.03 | Facility | None | $151.36 | $151.36 | $263.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $13.18 Median $74.13 Typical High $186.21 | Professional | None | $13.18 | $74.13 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $165.96 | Professional | None | $58.88 | $107.15 | $165.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $181.97 Typical High $4,897.79 | Facility | None | $85.11 | $181.97 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $186.21 | Professional | None | $89.13 | $144.54 | $186.21 |
Priority Health Setting Professional Modifier None Typical Low $58.88 Median $107.15 Typical High $165.96 | Professional | None | $58.88 | $107.15 | $165.96 |
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 $125.89 Typical High $194.98 | Professional | None | $79.43 | $125.89 | $194.98 |
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 $43.65 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $43.65 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $17.78 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $66.07 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $13.18 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.91 | $13.18 | $17.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $56.23 Typical High $91.20 | Professional | 52 · Reduced service | $44.67 | $56.23 | $91.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.91 Typical High $36.31 | Professional | 53 · Discontinued | $17.78 | $22.91 | $36.31 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $85.11 Typical High $134.90 | Professional | 54 · Surgery only | $66.07 | $85.11 | $134.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.98 Typical High $26.92 | Professional | 55 · Aftercare only | $13.18 | $16.98 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $18.20 |
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· 41st of 51
$123
AK $309KY $97.72
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.