How much rates vary
Facilitymedian $2,951 · 10th to 90th $525 to $7,943Professionalmedian $1,072 · 10th to 90th $646 to $1,288
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 $1,071.52 Median $1,096.48 Typical High $6,918.31 | Facility | None | $1,071.52 | $1,096.48 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,148.15 | Professional | None | $851.14 | $1,096.48 | $1,148.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $9,120.11 | Facility | None | $2,951.21 | $3,801.89 | $9,120.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $218.78 Median $1,096.48 Typical High $1,174.90 | Professional | None | $218.78 | $1,096.48 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,230.27 | Professional | None | $602.56 | $1,047.13 | $1,230.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $4,897.79 | Facility | None | $1,023.29 | $2,290.87 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,096.48 | Professional | None | $776.25 | $977.24 | $1,096.48 |
Priority Health Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,230.27 | Professional | None | $562.34 | $776.25 | $1,230.27 |
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 $954.99 Median $1,230.27 Typical High $1,548.82 | Professional | None | $954.99 | $1,230.27 | $1,548.82 |
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 $426.58 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $426.58 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $645.65 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $85.11 | $109.65 | $114.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $512.86 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $776.25 | $794.33 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $107.15 |
Where Michigan sits
The same service costs 3.8 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· 31st of 51
$1,096
WI $3,090NY $813
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.