How much rates vary
Facilitymedian $468 · 10th to 90th $141 to $1,380Professionalmedian $105 · 10th to 90th $23 to $186
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 $87.10 Median $154.88 Typical High $4,897.79 | Facility | None | $87.10 | $154.88 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $158.49 | Professional | None | $85.11 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $42.66 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $16.98 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $64.57 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $12.88 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.51 | $11.48 | $15.49 |
BCBS Michigan Setting Facility Modifier None Typical Low $416.87 Median $467.74 Typical High $1,202.26 | Facility | None | $416.87 | $467.74 | $1,202.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $15.85 Median $93.33 Typical High $218.78 | Professional | None | $15.85 | $93.33 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $190.55 | Professional | None | $64.57 | $93.33 | $190.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $89.13 Median $407.38 Typical High $2,884.03 | Facility | None | $89.13 | $407.38 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $186.21 | Professional | None | $85.11 | $147.91 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $56.23 Typical High $77.62 | Professional | 52 · Reduced service | $41.69 | $56.23 | $77.62 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.95 Typical High $30.90 | Professional | 53 · Discontinued | $16.98 | $19.95 | $30.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $74.13 Typical High $117.49 | Professional | 54 · Surgery only | $63.10 | $74.13 | $117.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.79 Typical High $23.44 | Professional | 55 · Aftercare only | $12.59 | $14.79 | $23.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $15.49 |
Priority Health Setting Professional Modifier None Typical Low $61.66 Median $93.33 Typical High $177.83 | Professional | None | $61.66 | $93.33 | $177.83 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $186.21 | Professional | None | $79.43 | $134.90 | $186.21 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 59 · Distinct service | $58.88 | $58.88 | $58.88 |
Where Michigan sits
The same service costs 22.5 times more in Alabama 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.
Physician feeFacility fee
AL $5,010KY $223
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.