How much rates vary
Facilitymedian $347 · 10th to 90th $81 to $1,259Professionalmedian $63 · 10th to 90th $43 to $91
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 $57.54 Median $81.28 Typical High $2,041.74 | Facility | None | $57.54 | $81.28 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $85.11 | Professional | None | $42.66 | $61.66 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $81.28 | Professional | None | $36.31 | $56.23 | $81.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $977.24 | Facility | None | $309.03 | $398.11 | $977.24 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $85.11 | Professional | None | $28.18 | $48.98 | $85.11 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $83.18 | Professional | None | $58.88 | $60.26 | $83.18 |
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 $38.02 Median $61.66 Typical High $109.65 | Professional | None | $38.02 | $61.66 | $109.65 |
Health Alliance Plan Setting Facility Modifier None Typical Low $79.43 Median $407.38 Typical High $1,621.81 | Facility | None | $79.43 | $407.38 | $1,621.81 |
Health Alliance Plan Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $100.00 | Professional | None | $43.65 | $70.79 | $100.00 |
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 $35.48 Median $57.54 Typical High $87.10 | Professional | None | $35.48 | $57.54 | $87.10 |
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 $52.48 Median $64.57 Typical High $91.20 | Professional | None | $52.48 | $64.57 | $91.20 |
14 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 $28.84 Median $30.20 Typical High $41.69 | Professional | 52 · Reduced service | $28.84 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $16.60 | Professional | 53 · Discontinued | $11.48 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $44.67 Typical High $63.10 | Professional | 54 · Surgery only | $43.65 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $12.59 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.03 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.75 | $6.03 | $8.32 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $83.18 Typical High $100.00 | Professional | 50 · Both sides | $53.70 | $83.18 | $100.00 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $107.15 Typical High $125.89 | Professional | 50 · Both sides | $72.44 | $107.15 | $125.89 |
Health Alliance Plan Setting Facility Modifier 50 · Both sides Typical Low $141.25 Median $331.13 Typical High $707.95 | Facility | 50 · Both sides | $141.25 | $331.13 | $707.95 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $100.00 Typical High $371.54 | Professional | 50 · Both sides | $63.10 | $100.00 | $371.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $30.20 Typical High $42.66 | Professional | 52 · Reduced service | $28.84 | $30.20 | $42.66 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.02 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $12.02 | $16.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $44.67 Typical High $63.10 | Professional | 54 · Surgery only | $43.65 | $44.67 | $63.10 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $12.59 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.03 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.75 | $6.03 | $8.51 |
Where Michigan sits
The same service costs 4.2 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· 44th of 51
$63.10
AK $224FL $53.70
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.