How much rates vary
Facilitymedian $1,698 · 10th to 90th $182 to $3,467Professionalmedian $158 · 10th to 90th $110 to $234
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 $112.20 Median $181.97 Typical High $4,073.80 | Facility | None | $112.20 | $181.97 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $194.98 | Professional | None | $109.65 | $138.04 | $194.98 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,951.21 | Facility | None | $1,698.24 | $1,737.80 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $21.88 Median $128.82 Typical High $263.03 | Professional | None | $21.88 | $128.82 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $190.55 | Professional | None | $77.62 | $120.23 | $190.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $112.20 Median $457.09 Typical High $4,466.84 | Facility | None | $112.20 | $457.09 | $4,466.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $208.93 | Professional | None | $109.65 | $181.97 | $208.93 |
Priority Health Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $181.97 | Professional | None | $77.62 | $120.23 | $181.97 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,951.21 | Facility | None | $426.58 | $602.56 | $2,951.21 |
United Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $208.93 | Professional | None | $112.20 | $158.49 | $208.93 |
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 $54.95 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.92 Typical High $37.15 | Professional | 53 · Discontinued | $21.88 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $102.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.96 | $13.49 | $18.62 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $66.07 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $66.07 | $91.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $26.30 | $36.31 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $100.00 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $100.00 | $138.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.95 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $19.95 | $27.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $13.18 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $13.18 | $18.20 |
Where Michigan sits
The same service costs 3.2 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· 22nd of 51
$174
AK $407NJ $129
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.