How much rates vary
Facilitymedian $1,175 · 10th to 90th $490 to $3,802Professionalmedian $427 · 10th to 90th $269 to $513
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 $426.58 Median $436.52 Typical High $6,918.31 | Facility | None | $426.58 | $436.52 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $478.63 | Professional | None | $354.81 | $457.09 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,630.78 | Facility | None | $1,148.15 | $1,479.11 | $3,630.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $87.10 Median $436.52 Typical High $457.09 | Professional | None | $87.10 | $436.52 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $501.19 | Professional | None | $239.88 | $416.87 | $501.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $407.38 Median $891.25 Typical High $4,897.79 | Facility | None | $407.38 | $891.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $467.74 | Professional | None | $309.03 | $398.11 | $467.74 |
Priority Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $501.19 | Professional | None | $223.87 | $309.03 | $501.19 |
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 $380.19 Median $478.63 Typical High $588.84 | Professional | None | $380.19 | $478.63 | $588.84 |
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 $173.78 Median $218.78 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $257.04 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $43.65 | $45.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $309.03 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
Where Michigan sits
The same service costs 6.1 times more in Alaska than in Maryland. 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
AK $5,496MD $901
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.