How much rates vary
Facilitymedian $603 · 10th to 90th $120 to $1,259Professionalmedian $123 · 10th to 90th $50 to $275
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 $66.07 Median $257.04 Typical High $4,897.79 | Facility | None | $66.07 | $257.04 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $123.03 Typical High $251.19 | Professional | None | $44.67 | $123.03 | $251.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $602.56 Median $616.60 Typical High $1,071.52 | Facility | None | $602.56 | $616.60 | $1,071.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $39.81 Median $95.50 Typical High $338.84 | Professional | None | $39.81 | $95.50 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $154.88 Typical High $295.12 | Professional | None | $42.66 | $154.88 | $295.12 |
Health Alliance Plan Setting Facility Modifier None Typical Low $67.61 Median $467.74 Typical High $4,897.79 | Facility | None | $67.61 | $467.74 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $50.12 Median $186.21 Typical High $269.15 | Professional | None | $50.12 | $186.21 | $269.15 |
Priority Health Setting Professional Modifier None Typical Low $38.02 Median $154.88 Typical High $295.12 | Professional | None | $38.02 | $154.88 | $295.12 |
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 $58.88 Median $158.49 Typical High $218.78 | Professional | None | $58.88 | $158.49 | $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 $33.11 Median $83.18 Typical High $125.89 | Professional | 52 · Reduced service | $33.11 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $33.11 Typical High $51.29 | Professional | 53 · Discontinued | $13.18 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $125.89 Typical High $190.55 | Professional | 54 · Surgery only | $48.98 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $25.12 Typical High $38.02 | Professional | 55 · Aftercare only | $9.77 | $25.12 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $16.60 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.61 | $16.60 | $25.12 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $147.91 Typical High $512.86 | Professional | 50 · Both sides | $109.65 | $147.91 | $512.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $52.48 Typical High $138.04 | Professional | 52 · Reduced service | $32.36 | $52.48 | $138.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $21.38 Typical High $54.95 | Professional | 53 · Discontinued | $13.18 | $21.38 | $54.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $79.43 Typical High $204.17 | Professional | 54 · Surgery only | $48.98 | $79.43 | $204.17 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $40.74 | Professional | 55 · Aftercare only | $9.77 | $15.85 | $40.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.47 Typical High $27.54 | Professional | 56 · Pre-op care only | $6.46 | $10.47 | $27.54 |
Where Michigan sits
The same service costs 4.6 times more in Iowa 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.
Michigan· 37th of 51
$123
IA $288KY $63.10
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.