How much rates vary
Facilitymedian $5,012 · 10th to 90th $646 to $7,943Professionalmedian $603 · 10th to 90th $110 to $759
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 $630.96 Typical High $4,897.79 | Facility | None | $602.56 | $630.96 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | None | $501.19 | $602.56 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $8,709.64 | Facility | None | $5,011.87 | $5,128.61 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $109.65 Median $616.60 Typical High $691.83 | Professional | None | $109.65 | $616.60 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,000.00 | Professional | None | $380.19 | $602.56 | $1,000.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $630.96 Median $1,380.38 Typical High $6,918.31 | Facility | None | $630.96 | $1,380.38 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $724.44 | Professional | None | $512.86 | $602.56 | $724.44 |
Priority Health Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $954.99 | Professional | None | $363.08 | $575.44 | $954.99 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,309.57 | Facility | None | $602.56 | $1,230.27 | $6,309.57 |
United Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $870.96 | Professional | None | $549.54 | $741.31 | $870.96 |
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 $295.12 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $295.12 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 54 · Surgery only | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $302.00 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $60.26 |
Where Michigan sits
The same service costs 5.9 times more in Alaska 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
AK $8,723MT $1,483
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.