How much rates vary
Facilitymedian $100 · 10th to 90th $71 to $339Professionalmedian $76 · 10th to 90th $54 to $107
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 $61.66 Median $97.72 Typical High $4,897.79 | Facility | None | $61.66 | $97.72 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $100.00 | Professional | None | $61.66 | $74.13 | $100.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $204.17 | Facility | None | $70.79 | $91.20 | $204.17 |
BCBS Michigan Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $107.15 | Professional | None | $42.66 | $70.79 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $134.90 | Professional | None | $42.66 | $67.61 | $134.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $4,897.79 | Facility | None | $63.10 | $95.50 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $104.71 | Professional | None | $64.57 | $95.50 | $104.71 |
Priority Health Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $109.65 | Professional | None | $38.90 | $63.10 | $109.65 |
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 $54.95 Median $72.44 Typical High $95.50 | Professional | None | $54.95 | $72.44 | $95.50 |
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 $30.90 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $30.90 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $12.30 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $53.70 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.72 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $10.00 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 50 · Both sides | $173.78 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $32.36 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $32.36 | $48.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.88 Typical High $19.95 | Professional | 53 · Discontinued | $12.30 | $12.88 | $19.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $48.98 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $48.98 | $74.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $14.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $10.00 |
Where Michigan sits
The same service costs 3.6 times more in Alaska 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· 35th of 51
$75.86
AK $204KY $56.23
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.