How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,047 to $6,457Professionalmedian $1,072 · 10th to 90th $661 to $1,288
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 $1,023.29 Median $2,041.74 Typical High $4,897.79 | Facility | None | $1,023.29 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,071.52 | $1,071.52 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $5,495.41 | Facility | None | $3,162.28 | $3,162.28 | $5,495.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $213.80 Median $660.69 Typical High $1,071.52 | Professional | None | $213.80 | $660.69 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,380.38 | Professional | None | $616.60 | $977.24 | $1,380.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $2,630.27 Typical High $4,897.79 | Facility | None | $1,071.52 | $2,630.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,318.26 | Professional | None | $977.24 | $1,148.15 | $1,318.26 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,258.93 | Professional | None | $616.60 | $954.99 | $1,258.93 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,691.53 Typical High $9,120.11 | Facility | None | $891.25 | $2,691.53 | $9,120.11 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,230.27 | Professional | None | $891.25 | $1,096.48 | $1,230.27 |
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 $512.86 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in Kentucky. 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
AK $9,843KY $2,122
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.