How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $4,074Professionalmedian $513 · 10th to 90th $331 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 $436.52 Median $707.95 Typical High $5,754.40 | Facility | None | $436.52 | $707.95 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $512.86 | Professional | None | $331.13 | $446.68 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $302.00 | Professional | None | $151.36 | $151.36 | $302.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,905.46 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $79.43 Median $501.19 Typical High $707.95 | Professional | None | $79.43 | $501.19 | $707.95 |
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 $288.40 Median $436.52 Typical High $1,096.48 | Professional | None | $288.40 | $436.52 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $562.34 Median $1,479.11 Typical High $4,897.79 | Facility | None | $562.34 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $851.14 | Professional | None | $331.13 | $645.65 | $851.14 |
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 $263.03 Median $416.87 Typical High $724.44 | Professional | None | $263.03 | $416.87 | $724.44 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $380.19 Median $741.31 Typical High $812.83 | Professional | None | $380.19 | $741.31 | $812.83 |
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 $218.78 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $91.20 | Professional | 53 · Discontinued | $87.10 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $45.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $45.71 |
Where Michigan sits
The same service costs 6.1 times more in Oklahoma than in Montana. 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
OK $6,602MT $1,074
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.