How much rates vary
Facilitymedian $1,072 · 10th to 90th $437 to $2,188Professionalmedian $398 · 10th to 90th $275 to $490
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 $398.11 Median $407.38 Typical High $6,918.31 | Facility | None | $398.11 | $407.38 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $426.58 | Professional | None | $316.23 | $407.38 | $426.58 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,905.46 | Facility | None | $1,071.52 | $1,096.48 | $1,905.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $64.57 Median $398.11 Typical High $398.11 | Professional | None | $64.57 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $457.09 | Professional | None | $223.87 | $380.19 | $457.09 |
Health Alliance Plan Setting Facility Modifier None Typical Low $380.19 Median $912.01 Typical High $4,897.79 | Facility | None | $380.19 | $912.01 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | None | $316.23 | $380.19 | $478.63 |
Priority Health Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $457.09 | Professional | None | $208.93 | $281.84 | $457.09 |
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 $354.81 Median $446.68 Typical High $512.86 | Professional | None | $354.81 | $446.68 | $512.86 |
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 $158.49 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $158.49 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $239.88 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $60.26 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $40.74 | $42.66 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $190.55 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $281.84 | $295.12 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $58.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $39.81 |
Where Michigan sits
The same service costs 3.9 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· 38th of 51
$398
WI $1,175NY $302
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.