How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,047 to $18,621Professionalmedian $4,169 · 10th to 90th $537 to $7,244
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 $602.56 Median $4,897.79 Typical High $6,165.95 | Facility | None | $602.56 | $4,897.79 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $4,168.69 Typical High $5,888.44 | Professional | None | $467.74 | $4,168.69 | $5,888.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $1,995.26 Typical High $2,951.21 | Professional | 52 · Reduced service | $295.12 | $1,995.26 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $794.33 Typical High $1,174.90 | Professional | 53 · Discontinued | $117.49 | $794.33 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $3,019.95 Typical High $4,365.16 | Professional | 54 · Surgery only | $436.52 | $3,019.95 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $602.56 Typical High $870.96 | Professional | 55 · Aftercare only | $87.10 | $602.56 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $398.11 Typical High $588.84 | Professional | 56 · Pre-op care only | $58.88 | $398.11 | $588.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $20,892.96 | Facility | None | $12,022.64 | $12,022.64 | $20,892.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $114.82 Median $575.44 Typical High $7,244.36 | Professional | None | $114.82 | $575.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $7,585.78 | Professional | None | $389.05 | $707.95 | $7,585.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $630.96 Median $5,011.87 Typical High $16,982.44 | Facility | None | $630.96 | $5,011.87 | $16,982.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $562.34 Median $5,128.61 Typical High $6,309.57 | Professional | None | $562.34 | $5,128.61 | $6,309.57 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $295.12 Typical High $3,090.30 | Professional | 52 · Reduced service | $281.84 | $295.12 | $3,090.30 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $758.58 Typical High $1,230.27 | Professional | 53 · Discontinued | $112.20 | $758.58 | $1,230.27 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $4,570.88 | Professional | 54 · Surgery only | $426.58 | $436.52 | $4,570.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $912.01 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $912.01 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $380.19 Typical High $616.60 | Professional | 56 · Pre-op care only | $56.23 | $380.19 | $616.60 |
Priority Health Setting Professional Modifier None Typical Low $323.59 Median $707.95 Typical High $6,309.57 | Professional | None | $323.59 | $707.95 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $4,466.84 Typical High $12,302.69 | Facility | None | $1,047.13 | $4,466.84 | $12,302.69 |
United Setting Professional Modifier None Typical Low $575.44 Median $3,890.45 Typical High $7,413.10 | Professional | None | $575.44 | $3,890.45 | $7,413.10 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | XS · Separate structure | $398.11 | $398.11 | $398.11 |
Where Michigan sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.