How much rates vary
Facilitymedian $3,388 · 10th to 90th $891 to $6,918Professionalmedian $191 · 10th to 90th $36 to $234
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 $194.98 Median $4,073.80 Typical High $5,754.40 | Facility | None | $194.98 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $204.17 | Professional | None | $158.49 | $199.53 | $204.17 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,388.44 Median $3,467.37 Typical High $5,888.44 | Facility | None | $3,388.44 | $3,467.37 | $5,888.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $32.36 Median $181.97 Typical High $190.55 | Professional | None | $32.36 | $181.97 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $239.88 | Professional | None | $109.65 | $177.83 | $239.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $407.38 Median $2,089.30 Typical High $4,897.79 | Facility | None | $407.38 | $2,089.30 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $234.42 | Professional | None | $162.18 | $186.21 | $234.42 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $239.88 | Professional | None | $102.33 | $144.54 | $239.88 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $9,549.93 | Facility | None | $891.25 | $2,818.38 | $9,549.93 |
United Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $257.04 | Professional | None | $169.82 | $208.93 | $257.04 |
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 $77.62 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $77.62 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $39.81 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $154.88 | Professional | 54 · Surgery only | $117.49 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $19.95 | $20.42 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $93.33 | $97.72 | $97.72 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $37.15 | $38.90 | $38.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $141.25 | $144.54 | $144.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $28.84 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $19.50 |
Where Michigan sits
The same service costs 20.4 times more in Kansas 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· 47th of 51
$195
KS $3,020NY $148
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.