How much rates vary
Facilitymedian $1,047 · 10th to 90th $126 to $1,995Professionalmedian $363 · 10th to 90th $229 to $692
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 $346.74 Median $1,000.00 Typical High $6,918.31 | Facility | None | $346.74 | $1,000.00 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | None | $346.74 | $363.08 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,819.70 | Facility | None | $1,047.13 | $1,071.52 | $1,819.70 |
BCBS Michigan Setting Professional Modifier None Typical Low $61.66 Median $363.08 Typical High $724.44 | Professional | None | $61.66 | $363.08 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $467.74 | Professional | None | $213.80 | $331.13 | $467.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $363.08 Median $870.96 Typical High $7,943.28 | Facility | None | $363.08 | $870.96 | $7,943.28 |
Health Alliance Plan Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $416.87 | Professional | None | $295.12 | $363.08 | $416.87 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $467.74 | Professional | None | $213.80 | $331.13 | $467.74 |
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 $302.00 Median $354.81 Typical High $389.05 | Professional | None | $302.00 | $354.81 | $389.05 |
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 $173.78 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $263.03 | $275.42 | $275.42 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $36.31 |
Where Michigan sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 29th of 51
$363
AK $1,096UT $229
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.