How much rates vary
Facilitymedian $3,981 · 10th to 90th $708 to $6,761Professionalmedian $398 · 10th to 90th $257 to $603
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 $588.84 Median $616.60 Typical High $6,918.31 | Facility | None | $588.84 | $616.60 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $616.60 | Professional | None | $467.74 | $602.56 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $6,918.31 | Facility | None | $3,981.07 | $3,981.07 | $6,918.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $100.00 Median $363.08 Typical High $588.84 | Professional | None | $100.00 | $363.08 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $1,380.38 | Professional | None | $288.40 | $446.68 | $1,380.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $676.08 Median $2,570.40 Typical High $4,897.79 | Facility | None | $676.08 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $602.56 | Professional | None | $269.15 | $380.19 | $602.56 |
Priority Health Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $645.65 | Professional | None | $309.03 | $416.87 | $645.65 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,025.60 | Facility | None | $602.56 | $1,230.27 | $6,025.60 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $588.84 | Professional | None | $263.03 | $331.13 | $588.84 |
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 $263.03 Median $302.00 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $398.11 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $91.20 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $60.26 | $61.66 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $288.40 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $436.52 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $57.54 | $60.26 | $60.26 |
Where Michigan sits
The same service costs 5.2 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· 33rd of 51
$537
AK $1,820KY $347
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.