How much rates vary
Facilitymedian $2,239 · 10th to 90th $490 to $4,365Professionalmedian $251 · 10th to 90th $54 to $363
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 $251.19 Median $257.04 Typical High $6,918.31 | Facility | None | $251.19 | $257.04 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | None | $234.42 | $251.19 | $251.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,890.45 | Facility | None | $2,238.72 | $2,238.72 | $3,890.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $269.15 | Professional | None | $45.71 | $53.70 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $691.83 | Professional | None | $154.88 | $275.42 | $691.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $257.04 Median $1,862.09 Typical High $5,754.40 | Facility | None | $257.04 | $1,862.09 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $302.00 | Professional | None | $194.98 | $251.19 | $302.00 |
Priority Health Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $616.60 | Professional | None | $154.88 | $269.15 | $616.60 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $426.58 | Professional | None | $229.09 | $281.84 | $426.58 |
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 $117.49 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $173.78 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $38.02 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $25.12 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $186.21 | $186.21 | $186.21 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $37.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Where Michigan sits
The same service costs 7.6 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 $4,681MT $618
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.