How much rates vary
Facilitymedian $5,129 · 10th to 90th $955 to $11,482Professionalmedian $513 · 10th to 90th $69 to $1,349
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 $346.74 Median $1,071.52 Typical High $4,897.79 | Facility | None | $346.74 | $1,071.52 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $831.76 Typical High $1,174.90 | Professional | None | $251.19 | $831.76 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | None | $147.91 | $147.91 | $223.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,570.88 Median $6,165.95 Typical High $14,125.38 | Facility | None | $4,570.88 | $6,165.95 | $14,125.38 |
BCBS Michigan Setting Professional Modifier None Typical Low $57.54 Median $338.84 Typical High $512.86 | Professional | None | $57.54 | $338.84 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $1,548.82 | Professional | None | $251.19 | $660.69 | $1,548.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $363.08 Median $2,754.23 Typical High $4,897.79 | Facility | None | $363.08 | $2,754.23 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $295.12 Median $1,023.29 Typical High $1,348.96 | Professional | None | $295.12 | $1,023.29 | $1,348.96 |
Priority Health Setting Professional Modifier None Typical Low $251.19 Median $645.65 Typical High $1,380.38 | Professional | None | $251.19 | $645.65 | $1,380.38 |
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 $316.23 Median $758.58 Typical High $1,819.70 | Professional | None | $316.23 | $758.58 | $1,819.70 |
11 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 $173.78 Median $436.52 Typical High $549.54 | Professional | 52 · Reduced service | $173.78 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $173.78 Typical High $218.78 | Professional | 53 · Discontinued | $69.18 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $645.65 Typical High $831.76 | Professional | 54 · Surgery only | $263.03 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $128.82 Typical High $165.96 | Professional | 55 · Aftercare only | $52.48 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $87.10 Typical High $109.65 | Professional | 56 · Pre-op care only | $34.67 | $87.10 | $109.65 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $549.54 Typical High $1,995.26 | Professional | 50 · Both sides | $549.54 | $549.54 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $354.81 Typical High $549.54 | Professional | 52 · Reduced service | $165.96 | $354.81 | $549.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $141.25 Typical High $223.87 | Professional | 53 · Discontinued | $66.07 | $141.25 | $223.87 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $524.81 Typical High $831.76 | Professional | 54 · Surgery only | $251.19 | $524.81 | $831.76 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $104.71 Typical High $165.96 | Professional | 55 · Aftercare only | $50.12 | $104.71 | $165.96 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $70.79 Typical High $112.20 | Professional | 56 · Pre-op care only | $33.11 | $70.79 | $112.20 |
Where Michigan sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 47th of 51
$513
WI $1,380HI $324
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.