How much rates vary
Facilitymedian $200 · 10th to 90th $126 to $562Professionalmedian $170 · 10th to 90th $126 to $229
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 $141.25 Median $147.91 Typical High $190.55 | Facility | None | $141.25 | $147.91 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $194.98 | Professional | None | $138.04 | $151.36 | $194.98 |
BCBS Michigan Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $501.19 | Facility | None | $173.78 | $223.87 | $501.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $30.90 Median $218.78 Typical High $239.88 | Professional | None | $30.90 | $218.78 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $234.42 | Professional | None | $93.33 | $144.54 | $234.42 |
Health Alliance Plan Setting Facility Modifier None Typical Low $63.10 Median $154.88 Typical High $426.58 | Facility | None | $63.10 | $154.88 | $426.58 |
Health Alliance Plan Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | None | $144.54 | $169.82 | $194.98 |
Priority Health Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $194.98 | Professional | None | $85.11 | $138.04 | $194.98 |
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 $125.89 Median $158.49 Typical High $181.97 | Professional | None | $125.89 | $158.49 | $181.97 |
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 $70.79 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $70.79 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $28.18 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.88 Typical High $28.18 | Professional | 55 · Aftercare only | $21.38 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $18.62 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 50 · Both sides | $223.87 | $223.87 | $223.87 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $363.08 Typical High $363.08 | Professional | 50 · Both sides | $245.47 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $74.13 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $74.13 | $95.50 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $30.20 | $38.02 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $28.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $19.05 |
Where Michigan sits
The same service costs 4.3 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· 26th of 51
$170
AK $457KY $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.