How much rates vary
Facilitymedian $1,778 · 10th to 90th $525 to $5,129Professionalmedian $646 · 10th to 90th $417 to $813
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 $645.65 Median $660.69 Typical High $6,918.31 | Facility | None | $645.65 | $660.69 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $691.83 | Professional | None | $537.03 | $660.69 | $691.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,778.28 | $2,290.87 | $5,495.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $630.96 Typical High $660.69 | Professional | None | $112.20 | $630.96 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $741.31 | Professional | None | $363.08 | $645.65 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $616.60 Median $1,479.11 Typical High $4,897.79 | Facility | None | $616.60 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $707.95 | Professional | None | $501.19 | $616.60 | $707.95 |
Priority Health Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $933.25 | Professional | None | $338.84 | $645.65 | $933.25 |
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 $588.84 Median $776.25 Typical High $933.25 | Professional | None | $588.84 | $776.25 | $933.25 |
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 $269.15 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $269.15 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $66.07 | $69.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
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· 37th of 51
$661
WI $1,905NY $490
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.