How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $5,754Professionalmedian $1,023 · 10th to 90th $603 to $1,288
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 $1,071.52 Median $4,786.30 Typical High $4,897.79 | Facility | None | $1,071.52 | $4,786.30 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,202.26 | Professional | None | $776.25 | $1,148.15 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $5,248.07 | Facility | None | $3,019.95 | $3,019.95 | $5,248.07 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $602.56 Typical High $954.99 | Professional | None | $162.18 | $602.56 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,258.93 | Professional | None | $602.56 | $1,071.52 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $2,454.71 Typical High $5,011.87 | Facility | None | $1,071.52 | $2,454.71 | $5,011.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,202.26 | Professional | None | $776.25 | $1,047.13 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,258.93 | Professional | None | $575.44 | $776.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $7,762.47 | Facility | None | $794.33 | $2,137.96 | $7,762.47 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,548.82 | Professional | None | $977.24 | $1,230.27 | $1,548.82 |
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 $436.52 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $436.52 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $114.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Where Michigan sits
The same service costs 8.4 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 $15,863KY $1,884
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.