How much rates vary
Facilitymedian $2,818 · 10th to 90th $501 to $4,898Professionalmedian $1,023 · 10th to 90th $661 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 $1,023.29 Median $1,047.13 Typical High $6,918.31 | Facility | None | $1,023.29 | $1,047.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,096.48 | Professional | None | $812.83 | $1,047.13 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $4,897.79 | Facility | None | $2,818.38 | $2,884.03 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $208.93 Median $1,000.00 Typical High $1,047.13 | Professional | None | $208.93 | $1,000.00 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,174.90 | Professional | None | $575.44 | $1,000.00 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $2,398.83 Typical High $4,897.79 | Facility | None | $977.24 | $2,398.83 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,174.90 | Professional | None | $812.83 | $977.24 | $1,174.90 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,479.11 | Professional | None | $537.03 | $1,000.00 | $1,479.11 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,513.56 | Professional | None | $933.25 | $1,174.90 | $1,513.56 |
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 $407.38 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $165.96 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $123.03 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $81.28 | $104.71 | $109.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $204.17 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $741.31 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $102.33 |
Where Michigan sits
The same service costs 3.8 times more in Wisconsin 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· 31st of 51
$1,047
WI $2,951NY $776
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.