How much rates vary
Facilitymedian $78 · 10th to 90th $46 to $537Professionalmedian $60 · 10th to 90th $37 to $87
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 $52.48 Median $83.18 Typical High $4,897.79 | Facility | None | $52.48 | $83.18 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $83.18 | Professional | None | $37.15 | $53.70 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $117.49 | Professional | None | $66.07 | $117.49 | $117.49 |
BCBS Michigan Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $79.43 | Facility | None | $45.71 | $45.71 | $79.43 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.22 Median $60.26 Typical High $112.20 | Professional | None | $11.22 | $60.26 | $112.20 |
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 $34.67 Median $57.54 Typical High $104.71 | Professional | None | $34.67 | $57.54 | $104.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $45.71 Median $144.54 Typical High $2,041.74 | Facility | None | $45.71 | $144.54 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $83.18 | Professional | None | $39.81 | $61.66 | $83.18 |
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 $33.11 Median $53.70 Typical High $83.18 | Professional | None | $33.11 | $53.70 | $83.18 |
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 $46.77 Median $60.26 Typical High $75.86 | Professional | None | $46.77 | $60.26 | $75.86 |
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 $26.30 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $26.30 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.75 Typical High $16.60 | Professional | 53 · Discontinued | $10.47 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $44.67 Typical High $63.10 | Professional | 54 · Surgery only | $38.90 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.91 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $8.91 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.25 | $5.89 | $8.32 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $27.54 Typical High $41.69 | Professional | 52 · Reduced service | $26.30 | $27.54 | $41.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $16.60 | Professional | 53 · Discontinued | $10.47 | $10.96 | $16.60 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $40.74 Typical High $63.10 | Professional | 54 · Surgery only | $38.90 | $40.74 | $63.10 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $12.59 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $8.32 |
Where Michigan sits
The same service costs 3.5 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· 39th of 51
$60.26
AK $178FL $51.29
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.