How much rates vary
Facilitymedian $16,596 · 10th to 90th $2,630 to $45,709Professionalmedian $759 · 10th to 90th $331 to $2,692
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 $524.81 Median $2,630.27 Typical High $4,897.79 | Facility | None | $524.81 | $2,630.27 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,513.56 Typical High $2,691.53 | Professional | None | $346.74 | $1,513.56 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
BCBS Michigan Setting Facility Modifier None Typical Low $11,748.98 Median $24,547.09 Typical High $53,703.18 | Facility | None | $11,748.98 | $24,547.09 | $53,703.18 |
BCBS Michigan Setting Professional Modifier None Typical Low $97.72 Median $549.54 Typical High $758.58 | Professional | None | $97.72 | $549.54 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $1,230.27 Typical High $3,311.31 | Professional | None | $371.54 | $1,230.27 | $3,311.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $562.34 Median $4,073.80 Typical High $16,595.87 | Facility | None | $562.34 | $4,073.80 | $16,595.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $1,995.26 Typical High $2,691.53 | Professional | None | $467.74 | $1,995.26 | $2,691.53 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $1,479.11 Typical High $2,884.03 | Professional | None | $354.81 | $1,479.11 | $2,884.03 |
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 $1,737.80 Typical High $2,951.21 | Professional | None | $446.68 | $1,737.80 | $2,951.21 |
13 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 $257.04 Median $758.58 Typical High $1,348.96 | Professional | 52 · Reduced service | $257.04 | $758.58 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $302.00 Typical High $537.03 | Professional | 53 · Discontinued | $104.71 | $302.00 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $1,148.15 Typical High $2,041.74 | Professional | 54 · Surgery only | $389.05 | $1,148.15 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $229.09 Typical High $407.38 | Professional | 55 · Aftercare only | $77.62 | $229.09 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $151.36 Typical High $269.15 | Professional | 56 · Pre-op care only | $51.29 | $151.36 | $269.15 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 50 · Both sides | $346.74 | $346.74 | $363.08 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | 50 · Both sides | $812.83 | $812.83 | $812.83 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $323.59 Typical High $2,691.53 | Professional | 50 · Both sides | $154.88 | $323.59 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $676.08 Typical High $1,318.26 | Professional | 52 · Reduced service | $245.47 | $676.08 | $1,318.26 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $269.15 Typical High $524.81 | Professional | 53 · Discontinued | $97.72 | $269.15 | $524.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $1,000.00 Typical High $1,949.84 | Professional | 54 · Surgery only | $363.08 | $1,000.00 | $1,949.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $199.53 Typical High $389.05 | Professional | 55 · Aftercare only | $72.44 | $199.53 | $389.05 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $134.90 Typical High $263.03 | Professional | 56 · Pre-op care only | $48.98 | $134.90 | $263.03 |
Where Michigan sits
The same service costs 6.2 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
$759
WA $3,162MD $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.