How much rates vary
Facilitymedian $794 · 10th to 90th $87 to $3,548Professionalmedian $129 · 10th to 90th $51 to $209
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 $66.07 Median $154.88 Typical High $4,897.79 | Facility | None | $66.07 | $154.88 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $117.49 Typical High $165.96 | Professional | None | $47.86 | $117.49 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $724.44 Median $851.14 Typical High $1,174.90 | Facility | None | $724.44 | $851.14 | $1,174.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.02 Median $128.82 Typical High $186.21 | Professional | None | $38.02 | $128.82 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $112.20 Typical High $251.19 | Professional | None | $47.86 | $112.20 | $251.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $69.18 Median $389.05 Typical High $4,897.79 | Facility | None | $69.18 | $389.05 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $57.54 Median $158.49 Typical High $208.93 | Professional | None | $57.54 | $158.49 | $208.93 |
Priority Health Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $204.17 | Professional | None | $47.86 | $102.33 | $204.17 |
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 $61.66 Median $120.23 Typical High $245.47 | Professional | None | $61.66 | $120.23 | $245.47 |
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 $33.11 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $33.11 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $13.18 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $50.12 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $10.00 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.61 | $12.30 | $15.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $31.62 | $61.66 | $77.62 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $12.88 | $24.55 | $31.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $91.20 Typical High $117.49 | Professional | 54 · Surgery only | $47.86 | $91.20 | $117.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $18.20 Typical High $23.44 | Professional | 55 · Aftercare only | $9.55 | $18.20 | $23.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $12.30 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.31 | $12.30 | $15.85 |
Where Michigan sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$129
WI $234FL $85.11
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.