How much rates vary
Facilitymedian $794 · 10th to 90th $110 to $1,995Professionalmedian $145 · 10th to 90th $72 to $219
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 $107.15 Median $204.17 Typical High $2,884.03 | Facility | None | $107.15 | $204.17 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $204.17 | Professional | None | $58.88 | $138.04 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $1,380.38 | Facility | None | $794.33 | $794.33 | $1,380.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $22.91 Median $123.03 Typical High $288.40 | Professional | None | $22.91 | $123.03 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $204.17 | Professional | None | $144.54 | $151.36 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $134.90 Typical High $316.23 | Professional | None | $69.18 | $134.90 | $316.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $109.65 Median $891.25 Typical High $2,691.53 | Facility | None | $109.65 | $891.25 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $223.87 | Professional | None | $79.43 | $169.82 | $223.87 |
Priority Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $281.84 | Professional | None | $63.10 | $117.49 | $281.84 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $204.17 | Professional | None | $83.18 | $141.25 | $204.17 |
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 $52.48 Median $74.13 Typical High $102.33 | Professional | 52 · Reduced service | $52.48 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $29.51 Typical High $40.74 | Professional | 53 · Discontinued | $20.89 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $112.20 Typical High $154.88 | Professional | 54 · Surgery only | $79.43 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.39 Typical High $30.90 | Professional | 55 · Aftercare only | $15.85 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $14.79 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.47 | $14.79 | $20.42 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 50 · Both sides | $109.65 | $109.65 | $109.65 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $245.47 Typical High $436.52 | Professional | 50 · Both sides | $181.97 | $245.47 | $436.52 |
Health Alliance Plan Setting Facility Modifier 50 · Both sides Typical Low $724.44 Median $977.24 Typical High $2,137.96 | Facility | 50 · Both sides | $724.44 | $977.24 | $2,137.96 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $239.88 Typical High $1,023.29 | Professional | 50 · Both sides | $95.50 | $239.88 | $1,023.29 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $67.61 Typical High $104.71 | Professional | 52 · Reduced service | $52.48 | $67.61 | $104.71 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $41.69 | Professional | 53 · Discontinued | $20.89 | $26.92 | $41.69 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $79.43 | $102.33 | $158.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $31.62 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $31.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.47 | $13.49 | $20.89 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 30th of 51
$155
AK $417VA $107
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.