How much rates vary
Facilitymedian $1,622 · 10th to 90th $525 to $4,898Professionalmedian $589 · 10th to 90th $372 to $724
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 $588.84 Median $602.56 Typical High $6,918.31 | Facility | None | $588.84 | $602.56 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $616.60 | Professional | None | $478.63 | $602.56 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $5,011.87 | Facility | None | $1,621.81 | $2,041.74 | $5,011.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $120.23 Median $602.56 Typical High $645.65 | Professional | None | $120.23 | $602.56 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $676.08 | Professional | None | $331.13 | $588.84 | $676.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $562.34 Median $1,288.25 Typical High $4,897.79 | Facility | None | $562.34 | $1,288.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $630.96 | Professional | None | $446.68 | $562.34 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $676.08 | Professional | None | $309.03 | $426.58 | $676.08 |
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 $537.03 Median $691.83 Typical High $851.14 | Professional | None | $537.03 | $691.83 | $851.14 |
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 $239.88 Median $302.00 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $354.81 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $61.66 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $416.87 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $58.88 |
Where Michigan sits
The same service costs 4.1 times more in Wisconsin 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· 35th of 51
$603
WI $1,738KY $427
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.