How much rates vary
Facilitymedian $1,259 · 10th to 90th $501 to $3,802Professionalmedian $302 · 10th to 90th $178 to $832
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 $177.83 Median $549.54 Typical High $2,884.03 | Facility | None | $177.83 | $549.54 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $575.44 | Professional | None | $177.83 | $416.87 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $208.93 | Professional | None | $131.83 | $177.83 | $208.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $933.25 Median $954.99 Typical High $1,621.81 | Facility | None | $933.25 | $954.99 | $1,621.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $794.33 | Professional | None | $199.53 | $302.00 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $870.96 | Professional | None | $158.49 | $363.08 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $562.34 Median $1,949.84 Typical High $4,365.16 | Facility | None | $562.34 | $1,949.84 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier None Typical Low $181.97 Median $575.44 Typical High $870.96 | Professional | None | $181.97 | $575.44 | $870.96 |
Priority Health Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $776.25 | Professional | None | $165.96 | $346.74 | $776.25 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $199.53 Median $575.44 Typical High $870.96 | Professional | None | $199.53 | $575.44 | $870.96 |
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 $89.13 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $89.13 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $35.48 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $134.90 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $61.66 Typical High $83.18 | Professional | 55 · Aftercare only | $26.92 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $17.78 | $41.69 | $54.95 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $323.59 Typical High $1,174.90 | Professional | 50 · Both sides | $323.59 | $323.59 | $1,174.90 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $91.20 | $107.15 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $42.66 Typical High $114.82 | Professional | 53 · Discontinued | $36.31 | $42.66 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $162.18 Typical High $436.52 | Professional | 54 · Surgery only | $134.90 | $162.18 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $32.36 Typical High $87.10 | Professional | 55 · Aftercare only | $26.92 | $32.36 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $57.54 |
Where Michigan sits
The same service costs 4.5 times more in Colorado than in Maryland. 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.
Physician feeFacility fee
CO $4,866MD $1,088
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.