How much rates vary
Facilitymedian $251 · 10th to 90th $107 to $776Professionalmedian $52 · 10th to 90th $40 to $63
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 $54.95 Median $2,041.74 Typical High $4,897.79 | Facility | None | $54.95 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $56.23 | Professional | None | $45.71 | $56.23 | $56.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $436.52 | Facility | None | $251.19 | $257.04 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $54.95 | Professional | None | $31.62 | $51.29 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $72.44 | Professional | None | $29.51 | $50.12 | $72.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $54.95 Median $123.03 Typical High $4,897.79 | Facility | None | $54.95 | $123.03 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $58.88 | Professional | None | $41.69 | $52.48 | $58.88 |
Priority Health Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $72.44 | Professional | None | $28.18 | $44.67 | $72.44 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,258.93 | Facility | None | $91.20 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $70.79 | Professional | None | $46.77 | $57.54 | $70.79 |
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 $22.91 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $22.91 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $11.48 | Professional | 53 · Discontinued | $9.12 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $41.69 Typical High $42.66 | Professional | 54 · Surgery only | $34.67 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.57 | $5.62 | $5.62 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.47 | $10.96 | $10.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $39.81 | $40.74 | $40.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $5.50 |
Where Michigan sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 43rd of 51
$54.95
TN $398NY $42.66
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.