How much rates vary
Facilitymedian $1,778 · 10th to 90th $316 to $3,715Professionalmedian $282 · 10th to 90th $162 to $407
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 $169.82 Median $331.13 Typical High $4,073.80 | Facility | None | $169.82 | $331.13 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $346.74 | Professional | None | $169.82 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $66.07 | Professional | 53 · Discontinued | $33.88 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $128.82 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $33.11 |
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 $117.49 Median $199.53 Typical High $281.84 | Professional | None | $117.49 | $199.53 | $281.84 |
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 $128.82 Median $199.53 Typical High $416.87 | Professional | None | $128.82 | $199.53 | $416.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $173.78 Median $1,348.96 Typical High $5,248.07 | Facility | None | $173.78 | $1,348.96 | $5,248.07 |
Health Alliance Plan Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $416.87 | Professional | None | $169.82 | $316.23 | $416.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $114.82 | $165.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $39.81 Typical High $66.07 | Professional | 53 · Discontinued | $33.88 | $39.81 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $147.91 Typical High $245.47 | Professional | 54 · Surgery only | $125.89 | $147.91 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $48.98 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $33.11 |
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 $123.03 Median $190.55 Typical High $416.87 | Professional | None | $123.03 | $190.55 | $416.87 |
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 $162.18 Median $275.42 Typical High $398.11 | Professional | None | $162.18 | $275.42 | $398.11 |
1 more rate 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 59 · Distinct service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 59 · Distinct service | $120.23 | $120.23 | $120.23 |
Where Michigan sits
The same service costs 8.2 times more in Colorado than in West Virginia. 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 $4,192WV $514
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.