How much rates vary
Facilitymedian $3,388 · 10th to 90th $288 to $7,586Professionalmedian $191 · 10th to 90th $107 to $339
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 $117.49 Median $281.84 Typical High $4,897.79 | Facility | None | $117.49 | $281.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $213.80 Typical High $309.03 | Professional | None | $117.49 | $213.80 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $83.18 | Professional | None | $66.07 | $83.18 | $83.18 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,388.44 Median $4,365.16 Typical High $10,715.19 | Facility | None | $3,388.44 | $4,365.16 | $10,715.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $177.83 | Professional | None | $70.79 | $128.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $389.05 | Professional | None | $91.20 | $154.88 | $389.05 |
Health Alliance Plan Setting Facility Modifier None Typical Low $125.89 Median $691.83 Typical High $2,884.03 | Facility | None | $125.89 | $691.83 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $331.13 | Professional | None | $112.20 | $263.03 | $331.13 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $63.10 Median $154.88 Typical High $389.05 | Professional | None | $63.10 | $154.88 | $389.05 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $3,235.94 | Facility | None | $288.40 | $426.58 | $3,235.94 |
United Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $371.54 | Professional | None | $138.04 | $239.88 | $371.54 |
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 $57.54 Median $107.15 Typical High $144.54 | Professional | 52 · Reduced service | $57.54 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $23.44 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $87.10 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $17.38 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.75 | $21.38 | $28.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $74.13 Typical High $144.54 | Professional | 52 · Reduced service | $56.23 | $74.13 | $144.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $57.54 | Professional | 53 · Discontinued | $22.39 | $23.44 | $57.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $213.80 | Professional | 54 · Surgery only | $83.18 | $87.10 | $213.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $42.66 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $42.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $28.84 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $28.84 |
Where Michigan sits
The same service costs 10.4 times more in Colorado than in North Dakota. 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.
Physician feeFacility fee
CO $4,594ND $443
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.