How much rates vary
Facilitymedian $2,042 · 10th to 90th $646 to $4,266Professionalmedian $158 · 10th to 90th $102 to $200
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 $158.49 Median $2,041.74 Typical High $4,897.79 | Facility | None | $158.49 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | None | $134.90 | $162.18 | $162.18 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,548.13 | Facility | None | $2,041.74 | $2,041.74 | $3,548.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.30 Median $154.88 Typical High $154.88 | Professional | None | $26.30 | $154.88 | $154.88 |
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 $85.11 Median $144.54 Typical High $223.87 | Professional | None | $85.11 | $144.54 | $223.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $1,698.24 Typical High $4,897.79 | Facility | None | $338.84 | $1,698.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | None | $134.90 | $158.49 | $194.98 |
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 $81.28 Median $134.90 Typical High $223.87 | Professional | None | $81.28 | $134.90 | $223.87 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $204.17 | Professional | None | $144.54 | $181.97 | $204.17 |
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 $67.61 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $26.92 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $19.95 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $16.22 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $75.86 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $30.90 | $31.62 | $31.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $23.99 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $15.85 |
Where Michigan sits
The same service costs 12.9 times more in Arkansas 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· 45th of 51
$162
AR $1,585NY $123
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.