How much rates vary
Facilitymedian $2,089 · 10th to 90th $347 to $3,715Professionalmedian $316 · 10th to 90th $186 to $427
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 $229.09 Median $346.74 Typical High $4,897.79 | Facility | None | $229.09 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $354.81 | Professional | None | $218.78 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $162.18 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $24.55 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $3,630.78 | Facility | None | $2,089.30 | $2,089.30 | $3,630.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $138.04 Median $331.13 Typical High $331.13 | Professional | None | $138.04 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $467.74 | Professional | None | $165.96 | $245.47 | $467.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $234.42 Median $1,318.26 Typical High $4,897.79 | Facility | None | $234.42 | $1,318.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $446.68 | Professional | None | $213.80 | $331.13 | $446.68 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $107.15 | $109.65 | $162.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $66.07 | Professional | 53 · Discontinued | $42.66 | $44.67 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $158.49 | $165.96 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.11 Typical High $48.98 | Professional | 55 · Aftercare only | $31.62 | $33.11 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $33.11 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $380.19 | Professional | None | $154.88 | $229.09 | $380.19 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $407.38 | Professional | None | $199.53 | $288.40 | $407.38 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 58 · Staged procedure | $213.80 | $213.80 | $213.80 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $354.81 Median $549.54 Typical High $645.65 | Professional | 50 · Both sides | $354.81 | $549.54 | $645.65 |
Where Michigan sits
The same service costs 3.1 times more in Alaska than in New York. 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
$324
AK $794NY $257
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.