How much rates vary
Facilitymedian $2,188 · 10th to 90th $955 to $5,370Professionalmedian $2,884 · 10th to 90th $2,291 to $5,129
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 $2,818.38 Median $4,073.80 Typical High $5,754.40 | Facility | None | $2,818.38 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,818.38 | $2,884.03 | $2,884.03 |
BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $3,981.07 | Facility | None | $2,137.96 | $2,187.76 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $575.44 Median $3,388.44 Typical High $5,128.61 | Professional | None | $575.44 | $3,388.44 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,238.72 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,202.26 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,202.26 | $4,073.80 | $7,244.36 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,818.38 | $3,235.94 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,698.24 | $2,290.87 | $3,467.37 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,754.23 | $3,388.44 |
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 $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,412.54 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,137.96 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $281.84 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,412.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $562.34 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $281.84 |
Where Michigan sits
The same service costs 7.1 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· 20th of 51
$2,884
AK $9,772KY $1,380
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.