How much rates vary
Facilitymedian $7,762 · 10th to 90th $525 to $20,417Professionalmedian $3,020 · 10th to 90th $1,905 to $4,266
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 $2,884.03 Median $2,951.21 Typical High $6,918.31 | Facility | None | $2,884.03 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,691.53 | $2,951.21 | $3,090.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $7,762.47 Median $9,772.37 Typical High $23,988.33 | Facility | None | $7,762.47 | $9,772.37 | $23,988.33 |
BCBS Michigan Setting Professional Modifier None Typical Low $616.60 Median $3,019.95 Typical High $4,168.69 | Professional | None | $616.60 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,137.96 | $4,265.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,019.95 Median $8,317.64 Typical High $9,332.54 | Facility | None | $3,019.95 | $8,317.64 | $9,332.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,951.21 | $3,162.28 | $4,365.16 |
Priority Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,041.74 | $4,265.80 |
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 $1,995.26 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,630.27 | $3,801.89 |
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 $1,348.96 Median $1,479.11 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | 53 · Discontinued | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $457.09 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 56 · Pre-op care only | $269.15 | $295.12 | $309.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,479.11 | $1,513.56 | $1,513.56 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $588.84 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,187.76 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $295.12 | $302.00 | $302.00 |
Where Michigan sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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· 27th of 51
$3,090
AK $9,550SC $1,698
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.