How much rates vary
Facilitymedian $251 · 10th to 90th $120 to $1,000Professionalmedian $56 · 10th to 90th $44 to $89
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 $2,041.74 Typical High $4,897.79 | Facility | None | $53.70 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $53.70 Typical High $60.26 | Professional | None | $40.74 | $53.70 | $60.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $436.52 | Facility | None | $251.19 | $257.04 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.02 Median $85.11 Typical High $89.13 | Professional | None | $12.02 | $85.11 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $63.10 | Professional | None | $35.48 | $46.77 | $63.10 |
Health Alliance Plan Setting Facility Modifier None Typical Low $54.95 Median $144.54 Typical High $4,897.79 | Facility | None | $54.95 | $144.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $64.57 | Professional | None | $48.98 | $56.23 | $64.57 |
Priority Health Setting Professional Modifier None Typical Low $33.88 Median $44.67 Typical High $63.10 | Professional | None | $33.88 | $44.67 | $63.10 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,258.93 | Facility | None | $91.20 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $72.44 | Professional | None | $47.86 | $56.23 | $72.44 |
11 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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 58 · Staged procedure | $42.66 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 54 · Surgery only | $41.69 | $41.69 | $41.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Michigan sits
The same service costs 13.8 times more in Oklahoma than in New York. 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· 32nd of 51
$58.88
OK $575NY $41.69
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.