How much rates vary
Facilitymedian $309 · 10th to 90th $66 to $955Professionalmedian $51 · 10th to 90th $35 to $69
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 $45.71 Median $69.18 Typical High $2,884.03 | Facility | None | $45.71 | $69.18 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $69.18 | Professional | None | $33.88 | $45.71 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $56.23 Typical High $56.23 | Professional | None | $22.91 | $56.23 | $56.23 |
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 $22.39 Median $38.02 Typical High $69.18 | Professional | None | $22.39 | $38.02 | $69.18 |
CareSource Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $69.18 | Professional | None | $48.98 | $50.12 | $69.18 |
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 $29.51 Median $47.86 Typical High $83.18 | Professional | None | $29.51 | $47.86 | $83.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $48.98 Median $134.90 Typical High $2,818.38 | Facility | None | $48.98 | $134.90 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $72.44 | Professional | None | $34.67 | $53.70 | $72.44 |
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 $28.18 Median $45.71 Typical High $72.44 | Professional | None | $28.18 | $45.71 | $72.44 |
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 $41.69 Median $52.48 Typical High $66.07 | Professional | None | $41.69 | $52.48 | $66.07 |
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 $22.91 Median $24.55 Typical High $33.88 | Professional | 52 · Reduced service | $22.91 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.77 Typical High $13.80 | Professional | 53 · Discontinued | $9.12 | $9.77 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $36.31 Typical High $51.29 | Professional | 54 · Surgery only | $33.88 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.90 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.57 | $4.90 | $6.92 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $87.10 Typical High $102.33 | Professional | 50 · Both sides | $57.54 | $87.10 | $102.33 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $100.00 Typical High $141.25 | Professional | 50 · Both sides | $69.18 | $100.00 | $141.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $23.44 Typical High $34.67 | Professional | 52 · Reduced service | $22.91 | $23.44 | $34.67 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $13.80 | Professional | 53 · Discontinued | $9.12 | $9.33 | $13.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $35.48 Typical High $51.29 | Professional | 54 · Surgery only | $33.88 | $35.48 | $51.29 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $10.47 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $10.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $6.92 |
Where Michigan sits
The same service costs 4.1 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· 42nd of 51
$51.29
AK $174FL $42.66
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.