How much rates vary
Facilitymedian $933 · 10th to 90th $490 to $2,951Professionalmedian $331 · 10th to 90th $240 to $427
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 $331.13 Median $331.13 Typical High $6,918.31 | Facility | None | $331.13 | $331.13 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | None | $263.03 | $331.13 | $346.74 |
BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,754.23 | Facility | None | $891.25 | $1,148.15 | $2,754.23 |
BCBS Setting Professional Modifier None Typical Low $56.23 Median $331.13 Typical High $478.63 | Professional | None | $56.23 | $331.13 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $380.19 | Professional | None | $181.97 | $316.23 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $316.23 Median $691.83 Typical High $4,897.79 | Facility | None | $316.23 | $691.83 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | None | $239.88 | $316.23 | $398.11 |
Priority Health Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $380.19 | Professional | None | $169.82 | $234.42 | $380.19 |
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 $295.12 Median $371.54 Typical High $467.74 | Professional | None | $295.12 | $371.54 | $467.74 |
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 $131.83 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $67.61 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $33.88 | $34.67 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $63.10 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $234.42 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $31.62 | $32.36 | $32.36 |
Where Michigan sits
The same service costs 7.3 times more in Alaska than in Montana. 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 $5,199MT $710
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.