How much rates vary
Facilitymedian $1,175 · 10th to 90th $525 to $2,754Professionalmedian $309 · 10th to 90th $56 to $355
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 $316.23 Median $2,884.03 Typical High $4,897.79 | Facility | None | $316.23 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | None | $251.19 | $338.84 | $338.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,174.90 | $2,041.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $56.23 Median $208.93 Typical High $354.81 | Professional | None | $56.23 | $208.93 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $446.68 | Professional | None | $194.98 | $288.40 | $446.68 |
Health Alliance Plan Setting Facility Modifier None Typical Low $645.65 Median $776.25 Typical High $4,897.79 | Facility | None | $645.65 | $776.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $371.54 | Professional | None | $263.03 | $323.59 | $371.54 |
Priority Health Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $363.08 | Professional | None | $194.98 | $251.19 | $363.08 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $331.13 | Professional | None | $263.03 | $302.00 | $331.13 |
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 $158.49 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $33.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $158.49 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $32.36 |
Where Michigan sits
The same service costs 6.2 times more in Colorado 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
CO $4,689MT $752
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.