How much rates vary
Facilitymedian $2,884 · 10th to 90th $741 to $6,457Professionalmedian $282 · 10th to 90th $148 to $891
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 $194.98 Median $758.58 Typical High $4,897.79 | Facility | None | $194.98 | $758.58 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $602.56 Typical High $776.25 | Professional | None | $141.25 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $302.00 Typical High $389.05 | Professional | 52 · Reduced service | $97.72 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $120.23 Typical High $154.88 | Professional | 53 · Discontinued | $38.90 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $144.54 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $89.13 Typical High $117.49 | Professional | 55 · Aftercare only | $28.84 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $60.26 Typical High $77.62 | Professional | 56 · Pre-op care only | $19.50 | $60.26 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $7,762.47 | Facility | None | $2,570.40 | $3,467.37 | $7,762.47 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $281.84 | Professional | None | $117.49 | $204.17 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $426.58 Typical High $1,047.13 | Professional | None | $141.25 | $426.58 | $1,047.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $204.17 Median $1,905.46 Typical High $4,897.79 | Facility | None | $204.17 | $1,905.46 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $173.78 Median $660.69 Typical High $891.25 | Professional | None | $173.78 | $660.69 | $891.25 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $223.87 Typical High $389.05 | Professional | 52 · Reduced service | $93.33 | $223.87 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $89.13 Typical High $158.49 | Professional | 53 · Discontinued | $37.15 | $89.13 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $338.84 Typical High $588.84 | Professional | 54 · Surgery only | $138.04 | $338.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $67.61 Typical High $117.49 | Professional | 55 · Aftercare only | $27.54 | $67.61 | $117.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $44.67 Typical High $79.43 | Professional | 56 · Pre-op care only | $18.62 | $44.67 | $79.43 |
Priority Health Setting Professional Modifier None Typical Low $144.54 Median $436.52 Typical High $831.76 | Professional | None | $144.54 | $436.52 | $831.76 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,288.25 Typical High $2,089.30 | Facility | None | $302.00 | $1,288.25 | $2,089.30 |
United Setting Professional Modifier None Typical Low $177.83 Median $489.78 Typical High $977.24 | Professional | None | $177.83 | $489.78 | $977.24 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $302.00 Typical High $1,412.54 | Professional | 50 · Both sides | $302.00 | $302.00 | $1,412.54 |
Where Michigan sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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· 48th of 51
$282
WI $912NE $240
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.