How much rates vary
Facilitymedian $12,589 · 10th to 90th $2,692 to $32,359Professionalmedian $776 · 10th to 90th $355 to $2,754
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 $537.03 Median $2,691.53 Typical High $4,897.79 | Facility | None | $537.03 | $2,691.53 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,754.23 | Professional | None | $346.74 | $1,584.89 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $8,511.38 Median $17,378.01 Typical High $38,018.94 | Facility | None | $8,511.38 | $17,378.01 | $38,018.94 |
BCBS Michigan Setting Professional Modifier None Typical Low $97.72 Median $724.44 Typical High $776.25 | Professional | None | $97.72 | $724.44 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,737.80 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,380.38 Typical High $3,467.37 | Professional | None | $371.54 | $1,380.38 | $3,467.37 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $3,467.37 Typical High $6,165.95 | Facility | None | $575.44 | $3,467.37 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $478.63 Median $1,949.84 Typical High $2,754.23 | Professional | None | $478.63 | $1,949.84 | $2,754.23 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $1,479.11 Typical High $2,951.21 | Professional | None | $354.81 | $1,479.11 | $2,951.21 |
United Setting Facility Modifier None Typical Low $5,754.40 Median $9,549.93 Typical High $12,882.50 | Facility | None | $5,754.40 | $9,549.93 | $12,882.50 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,819.70 Typical High $2,884.03 | Professional | None | $446.68 | $1,819.70 | $2,884.03 |
14 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 $263.03 Median $794.33 Typical High $1,380.38 | Professional | 52 · Reduced service | $263.03 | $794.33 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $323.59 Typical High $549.54 | Professional | 53 · Discontinued | $104.71 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $1,202.26 Typical High $2,089.30 | Professional | 54 · Surgery only | $389.05 | $1,202.26 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $239.88 Typical High $416.87 | Professional | 55 · Aftercare only | $77.62 | $239.88 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $158.49 Typical High $275.42 | Professional | 56 · Pre-op care only | $52.48 | $158.49 | $275.42 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 50 · Both sides | $691.83 | $691.83 | $724.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 50 · Both sides | $831.76 | $831.76 | $831.76 |
Health Alliance Plan Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $9,332.54 Typical High $16,595.87 | Facility | 50 · Both sides | $2,951.21 | $9,332.54 | $16,595.87 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $977.24 Typical High $2,691.53 | Professional | 50 · Both sides | $467.74 | $977.24 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $691.83 Typical High $1,348.96 | Professional | 52 · Reduced service | $245.47 | $691.83 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $275.42 Typical High $537.03 | Professional | 53 · Discontinued | $97.72 | $275.42 | $537.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $1,023.29 Typical High $1,995.26 | Professional | 54 · Surgery only | $371.54 | $1,023.29 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $204.17 Typical High $407.38 | Professional | 55 · Aftercare only | $74.13 | $204.17 | $407.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $138.04 Typical High $269.15 | Professional | 56 · Pre-op care only | $48.98 | $138.04 | $269.15 |
Where Michigan sits
The same service costs 6.3 times more in Washington 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.
Michigan· 49th of 51
$776
WA $3,236MD $513
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.