How much rates vary
Facilitymedian $204 · 10th to 90th $145 to $631Professionalmedian $234 · 10th to 90th $148 to $363
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 $204.17 Median $354.81 Typical High $4,897.79 | Facility | None | $204.17 | $354.81 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | None | $204.17 | $251.19 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $457.09 | Facility | None | $162.18 | $208.93 | $457.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $39.81 Median $234.42 Typical High $524.81 | Professional | None | $39.81 | $234.42 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $467.74 | Professional | None | $131.83 | $223.87 | $467.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $144.54 Median $338.84 Typical High $4,897.79 | Facility | None | $144.54 | $338.84 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $354.81 | Professional | None | $208.93 | $281.84 | $354.81 |
Priority Health Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $331.13 | Professional | None | $131.83 | $204.17 | $331.13 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $316.23 | Professional | None | $169.82 | $234.42 | $316.23 |
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 $102.33 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $40.74 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $154.88 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $36.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $104.71 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $104.71 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $41.69 | $70.79 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $269.15 | Professional | 54 · Surgery only | $151.36 | $158.49 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $53.70 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $35.48 |
Where Michigan sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 43rd of 51
$234
AK $661MD $182
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.