How much rates vary
Facilitymedian $4,677 · 10th to 90th $525 to $12,303Professionalmedian $1,820 · 10th to 90th $1,148 to $2,291
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 $2,089.30 Median $2,137.96 Typical High $6,918.31 | Facility | None | $2,089.30 | $2,137.96 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $2,187.76 | Professional | None | $1,659.59 | $2,137.96 | $2,187.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $14,454.40 | Facility | None | $4,677.35 | $5,888.44 | $14,454.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $309.03 Median $1,819.70 Typical High $1,819.70 | Professional | None | $309.03 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,445.44 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $4,897.79 | Facility | None | $1,995.26 | $3,890.45 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,659.59 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,380.38 | $2,570.40 |
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 $1,737.80 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,737.80 | $2,238.72 | $2,818.38 |
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 $870.96 Median $1,071.52 Typical High $1,096.48 | Professional | 52 · Reduced service | $870.96 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $426.58 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,288.25 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $316.23 Typical High $331.13 | Professional | 55 · Aftercare only | $257.04 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $213.80 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $213.80 | $218.78 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $398.11 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,548.82 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $199.53 | $208.93 | $208.93 |
Where Michigan sits
The same service costs 4.7 times more in Alaska than in Arkansas. 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· 25th of 51
$1,950
AK $6,166AR $1,318
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.