How much rates vary
Facilitymedian $3,981 · 10th to 90th $891 to $7,079Professionalmedian $631 · 10th to 90th $427 to $741
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 $630.96 Median $4,073.80 Typical High $5,754.40 | Facility | None | $630.96 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $660.69 | Professional | None | $501.19 | $660.69 | $660.69 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $7,079.46 | Facility | None | $3,981.07 | $4,073.80 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $138.04 Median $691.83 Typical High $741.31 | Professional | None | $138.04 | $691.83 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $1,380.38 | Professional | None | $371.54 | $645.65 | $1,380.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $4,897.79 | Facility | None | $1,318.26 | $2,454.71 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $812.83 | Professional | None | $524.81 | $630.96 | $812.83 |
Priority Health Setting Professional Modifier None Typical Low $371.54 Median $645.65 Typical High $776.25 | Professional | None | $371.54 | $645.65 | $776.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $9,120.11 | Facility | None | $851.14 | $2,238.72 | $9,120.11 |
United Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $812.83 | Professional | None | $549.54 | $616.60 | $812.83 |
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 $281.84 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $123.03 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $457.09 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $63.10 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in New York. 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· 40th of 51
$631
AK $1,905NY $490
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.