How much rates vary
Facilitymedian $1,778 · 10th to 90th $589 to $3,715Professionalmedian $209 · 10th to 90th $43 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 $208.93 Median $2,884.03 Typical High $4,897.79 | Facility | None | $208.93 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $213.80 Typical High $223.87 | Professional | None | $177.83 | $213.80 | $223.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,778.28 | $1,819.70 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $36.31 Median $204.17 Typical High $213.80 | Professional | None | $36.31 | $204.17 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $562.34 | Professional | None | $120.23 | $218.78 | $562.34 |
Health Alliance Plan Setting Facility Modifier None Typical Low $416.87 Median $1,202.26 Typical High $4,897.79 | Facility | None | $416.87 | $1,202.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $251.19 | Professional | None | $169.82 | $213.80 | $251.19 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $501.19 | Professional | None | $120.23 | $186.21 | $501.19 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $269.15 | Professional | None | $181.97 | $199.53 | $269.15 |
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 $95.50 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $95.50 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $38.02 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $165.96 | Professional | 54 · Surgery only | $141.25 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $32.36 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $22.39 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $102.33 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $40.74 | $42.66 | $42.66 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 54 · Surgery only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $30.90 | $31.62 | $31.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $21.38 |
Where Michigan sits
The same service costs 13.0 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $6,260MT $480
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.