How much rates vary
Facilitymedian $4,266 · 10th to 90th $490 to $7,413Professionalmedian $316 · 10th to 90th $204 to $372
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 $323.59 Median $346.74 Typical High $4,897.79 | Facility | None | $323.59 | $346.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $363.08 | Professional | None | $251.19 | $331.13 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,365.16 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $323.59 | Professional | None | $204.17 | $275.42 | $323.59 |
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 $186.21 Median $331.13 Typical High $870.96 | Professional | None | $186.21 | $331.13 | $870.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $331.13 Median $1,737.80 Typical High $10,232.93 | Facility | None | $331.13 | $1,737.80 | $10,232.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $407.38 | Professional | None | $257.04 | $323.59 | $407.38 |
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 $186.21 Median $288.40 Typical High $758.58 | Professional | None | $186.21 | $288.40 | $758.58 |
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 $281.84 Median $309.03 Typical High $416.87 | Professional | None | $281.84 | $309.03 | $416.87 |
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 $147.91 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $34.67 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 58 · Staged procedure | $151.36 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $158.49 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $239.88 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $33.11 |
Where Michigan sits
The same service costs 8.5 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 $6,252MT $735
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.