How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $5,888Professionalmedian $1,349 · 10th to 90th $871 to $1,660
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 $1,348.96 Median $1,380.38 Typical High $6,918.31 | Facility | None | $1,348.96 | $1,380.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,380.38 | $1,445.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $3,801.89 Typical High $6,456.54 | Facility | None | $3,715.35 | $3,801.89 | $6,456.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $275.42 Median $1,318.26 Typical High $1,380.38 | Professional | None | $275.42 | $1,318.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $1,548.82 | Professional | None | $758.58 | $1,318.26 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $1,288.25 | $3,162.28 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,288.25 | $1,548.82 |
Priority Health Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,548.82 | Professional | None | $707.95 | $977.24 | $1,548.82 |
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 $1,230.27 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,548.82 | $1,995.26 |
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 $537.03 Median $691.83 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $218.78 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $208.93 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $144.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Where Michigan sits
The same service costs 3.7 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· 31st of 51
$1,349
AK $3,802NY $1,023
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.