How much rates vary
Facilitymedian $646 · 10th to 90th $91 to $2,042Professionalmedian $129 · 10th to 90th $65 to $245
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 $83.18 Median $234.42 Typical High $4,897.79 | Facility | None | $83.18 | $234.42 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $229.09 | Professional | None | $60.26 | $147.91 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $912.01 | Facility | None | $575.44 | $676.08 | $912.01 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.38 Median $128.82 Typical High $309.03 | Professional | None | $17.38 | $128.82 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $162.18 Typical High $371.54 | Professional | None | $67.61 | $162.18 | $371.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $91.20 Median $467.74 Typical High $2,041.74 | Facility | None | $91.20 | $467.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $77.62 Median $181.97 Typical High $245.47 | Professional | None | $77.62 | $181.97 | $245.47 |
Priority Health Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $323.59 | Professional | None | $67.61 | $158.49 | $323.59 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,089.30 | Facility | None | $302.00 | $1,288.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $218.78 | Professional | None | $79.43 | $169.82 | $218.78 |
11 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 $41.69 Median $74.13 Typical High $114.82 | Professional | 52 · Reduced service | $41.69 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $29.51 Typical High $46.77 | Professional | 53 · Discontinued | $16.60 | $29.51 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $109.65 Typical High $173.78 | Professional | 54 · Surgery only | $63.10 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $21.88 Typical High $34.67 | Professional | 55 · Aftercare only | $12.59 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.32 | $15.49 | $22.91 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $186.21 Typical High $457.09 | Professional | 50 · Both sides | $138.04 | $186.21 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $67.61 Typical High $123.03 | Professional | 52 · Reduced service | $42.66 | $67.61 | $123.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.92 Typical High $48.98 | Professional | 53 · Discontinued | $16.98 | $26.92 | $48.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $100.00 Typical High $186.21 | Professional | 54 · Surgery only | $64.57 | $100.00 | $186.21 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.95 Typical High $37.15 | Professional | 55 · Aftercare only | $12.88 | $19.95 | $37.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.49 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.51 | $13.49 | $24.55 |
Where Michigan sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 45th of 51
$129
NC $302IN $85.11
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.