How much rates vary
Facilitymedian $2,630 · 10th to 90th $513 to $4,786Professionalmedian $1,047 · 10th to 90th $676 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 $1,096.48 Typical High $6,918.31 | Facility | None | $1,071.52 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,202.26 | Professional | None | $851.14 | $1,096.48 | $1,202.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $4,677.35 | Facility | None | $2,630.27 | $2,691.53 | $4,677.35 |
BCBS Michigan Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,047.13 | Professional | None | $645.65 | $1,000.00 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,258.93 | Professional | None | $602.56 | $1,023.29 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $6,606.93 | Facility | None | $1,023.29 | $2,344.23 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,202.26 | Professional | None | $812.83 | $954.99 | $1,202.26 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,258.93 | Professional | None | $562.34 | $741.31 | $1,258.93 |
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 $954.99 Median $1,202.26 Typical High $1,513.56 | Professional | None | $954.99 | $1,202.26 | $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 $436.52 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $549.54 | $575.44 |
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 $645.65 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $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 $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
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 $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Where Michigan sits
The same service costs 4.6 times more in Alaska 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.
Michigan· 32nd of 51
$1,047
AK $3,090KY $676
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.