How much rates vary
Facilitymedian $309 · 10th to 90th $79 to $708Professionalmedian $78 · 10th to 90th $56 to $107
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 $72.44 Median $107.15 Typical High $4,897.79 | Facility | None | $72.44 | $107.15 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $112.20 | Professional | None | $72.44 | $83.18 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $549.54 | Facility | None | $309.03 | $316.23 | $549.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.30 Median $60.26 Typical High $107.15 | Professional | None | $12.30 | $60.26 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $104.71 | Professional | None | $74.13 | $77.62 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $131.83 | Professional | None | $46.77 | $77.62 | $131.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $64.57 Median $91.20 Typical High $2,041.74 | Facility | None | $64.57 | $91.20 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $112.20 | Professional | None | $74.13 | $89.13 | $112.20 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $104.71 | Professional | None | $46.77 | $72.44 | $104.71 |
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 $63.10 Median $79.43 Typical High $97.72 | Professional | None | $63.10 | $79.43 | $97.72 |
12 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 $36.31 Median $37.15 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $21.38 | Professional | 53 · Discontinued | $14.45 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $56.23 Typical High $79.43 | Professional | 54 · Surgery only | $53.70 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $15.85 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $10.72 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $138.04 Typical High $162.18 | Professional | 50 · Both sides | $91.20 | $138.04 | $162.18 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $199.53 Typical High $213.80 | Professional | 50 · Both sides | $91.20 | $199.53 | $213.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $38.02 Typical High $53.70 | Professional | 52 · Reduced service | $36.31 | $38.02 | $53.70 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $21.38 | Professional | 53 · Discontinued | $14.79 | $15.14 | $21.38 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $57.54 Typical High $81.28 | Professional | 54 · Surgery only | $54.95 | $57.54 | $81.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $16.22 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $16.22 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $10.72 |
Where Michigan sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 40th of 51
$77.62
AK $229FL $67.61
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.