How much rates vary
Facilitymedian $151 · 10th to 90th $89 to $631Professionalmedian $81 · 10th to 90th $41 to $120
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 $44.67 Median $97.72 Typical High $2,884.03 | Facility | None | $44.67 | $97.72 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $102.33 | Professional | None | $44.67 | $66.07 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $28.84 Median $89.13 Typical High $89.13 | Professional | None | $28.84 | $89.13 | $89.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $131.83 Median $134.90 Typical High $229.09 | Facility | None | $131.83 | $134.90 | $229.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $33.88 Median $81.28 Typical High $147.91 | Professional | None | $33.88 | $81.28 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $91.20 | Professional | None | $30.90 | $60.26 | $91.20 |
Health Alliance Plan Setting Facility Modifier None Typical Low $46.77 Median $223.87 Typical High $630.96 | Facility | None | $46.77 | $223.87 | $630.96 |
Health Alliance Plan Setting Professional Modifier None Typical Low $43.65 Median $93.33 Typical High $114.82 | Professional | None | $43.65 | $93.33 | $114.82 |
Priority Health Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $91.20 | Professional | None | $30.90 | $57.54 | $91.20 |
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 $40.74 Median $74.13 Typical High $104.71 | Professional | None | $40.74 | $74.13 | $104.71 |
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 $22.39 Median $36.31 Typical High $48.98 | Professional | 52 · Reduced service | $22.39 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.45 Typical High $19.50 | Professional | 53 · Discontinued | $8.91 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $54.95 Typical High $72.44 | Professional | 54 · Surgery only | $33.11 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.96 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.62 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.47 | $5.62 | $9.77 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $28.18 Typical High $50.12 | Professional | 52 · Reduced service | $21.88 | $28.18 | $50.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.22 Typical High $19.95 | Professional | 53 · Discontinued | $8.71 | $11.22 | $19.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $42.66 Typical High $74.13 | Professional | 54 · Surgery only | $32.36 | $42.66 | $74.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.51 Typical High $15.14 | Professional | 55 · Aftercare only | $6.46 | $8.51 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.62 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.37 | $5.62 | $10.00 |
Where Michigan sits
The same service costs 3.7 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· 22nd of 51
$81.28
AK $178KY $47.86
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.