How much rates vary
Facilitymedian $2,344 · 10th to 90th $501 to $4,266Professionalmedian $661 · 10th to 90th $417 to $1,047
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 $630.96 Median $645.65 Typical High $6,918.31 | Facility | None | $630.96 | $645.65 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | None | $588.84 | $660.69 | $660.69 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,344.23 Median $2,398.83 Typical High $4,073.80 | Facility | None | $2,344.23 | $2,398.83 | $4,073.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $128.82 Median $645.65 Typical High $645.65 | Professional | None | $128.82 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $724.44 Typical High $891.25 | Professional | None | $354.81 | $724.44 | $891.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $4,897.79 | Facility | None | $630.96 | $1,995.26 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $954.99 | Professional | None | $562.34 | $676.08 | $954.99 |
Priority Health Setting Professional Modifier None Typical Low $331.13 Median $724.44 Typical High $912.01 | Professional | None | $331.13 | $724.44 | $912.01 |
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 $724.44 Median $1,000.00 Typical High $1,258.93 | Professional | None | $724.44 | $1,000.00 | $1,258.93 |
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 $288.40 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $66.07 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $120.23 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Where Michigan sits
The same service costs 13.6 times more in Colorado 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
CO $15,162MD $1,112
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.