How much rates vary
Facilitymedian $3,981 · 10th to 90th $851 to $7,079Professionalmedian $347 · 10th to 90th $282 to $550
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 $331.13 Median $4,073.80 Typical High $5,754.40 | Facility | None | $331.13 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $354.81 | Professional | None | $302.00 | $346.74 | $354.81 |
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 $63.10 Median $371.54 Typical High $549.54 | Professional | None | $63.10 | $371.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $758.58 | Professional | None | $194.98 | $346.74 | $758.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $4,897.79 | Facility | None | $707.95 | $2,454.71 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $436.52 | Professional | None | $288.40 | $338.84 | $436.52 |
Priority Health Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $416.87 | Professional | None | $194.98 | $346.74 | $416.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $457.09 | Professional | None | $302.00 | $346.74 | $457.09 |
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 $151.36 Median $173.78 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $35.48 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $64.57 | $67.61 | $67.61 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $245.47 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $33.88 |
Where Michigan sits
The same service costs 13.0 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 $10,613MT $815
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.