How much rates vary
Facilitymedian $2,239 · 10th to 90th $145 to $5,495Professionalmedian $145 · 10th to 90th $69 to $219
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 $89.13 Median $199.53 Typical High $2,041.74 | Facility | None | $89.13 | $199.53 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $204.17 | Professional | None | $89.13 | $165.96 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | None | $54.95 | $54.95 | $74.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $5,128.61 | Facility | None | $2,951.21 | $3,019.95 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $16.60 Median $102.33 Typical High $144.54 | Professional | None | $16.60 | $102.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $331.13 | Professional | None | $79.43 | $141.25 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $125.89 Median $1,819.70 Typical High $6,165.95 | Facility | None | $125.89 | $1,819.70 | $6,165.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $91.20 Median $181.97 Typical High $234.42 | Professional | None | $91.20 | $181.97 | $234.42 |
Priority Health Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $331.13 | Professional | None | $81.28 | $125.89 | $331.13 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,801.89 | Facility | None | $426.58 | $602.56 | $3,801.89 |
United Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $239.88 | Professional | None | $91.20 | $165.96 | $239.88 |
11 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 $43.65 Median $75.86 Typical High $102.33 | Professional | 52 · Reduced service | $43.65 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $30.20 Typical High $40.74 | Professional | 53 · Discontinued | $17.78 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $66.07 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $22.39 Typical High $30.90 | Professional | 55 · Aftercare only | $13.18 | $22.39 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $15.14 Typical High $20.42 | Professional | 56 · Pre-op care only | $8.71 | $15.14 | $20.42 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $154.88 Typical High $436.52 | Professional | 50 · Both sides | $154.88 | $154.88 | $436.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $54.95 Typical High $104.71 | Professional | 52 · Reduced service | $45.71 | $54.95 | $104.71 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $41.69 | Professional | 53 · Discontinued | $18.62 | $21.88 | $41.69 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $83.18 Typical High $154.88 | Professional | 54 · Surgery only | $69.18 | $83.18 | $154.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.60 Typical High $30.90 | Professional | 55 · Aftercare only | $13.80 | $16.60 | $30.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $20.89 |
Where Michigan sits
The same service costs 9.7 times more in Colorado than in Montana. 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 $4,351MT $447
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.