How much rates vary
Facilitymedian $1,778 · 10th to 90th $490 to $3,311Professionalmedian $126 · 10th to 90th $25 to $269
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 $109.65 Median $245.47 Typical High $4,897.79 | Facility | None | $109.65 | $245.47 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $251.19 | Professional | None | $109.65 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $83.18 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $33.11 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $186.21 | Professional | 54 · Surgery only | $83.18 | $123.03 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $37.15 | Professional | 55 · Aftercare only | $16.60 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.96 | $17.38 | $25.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $3,090.30 | Facility | None | $1,778.28 | $1,819.70 | $3,090.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $21.38 Median $79.43 Typical High $125.89 | Professional | None | $21.38 | $79.43 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $331.13 | Professional | None | $72.44 | $158.49 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $257.04 Median $630.96 Typical High $4,897.79 | Facility | None | $257.04 | $630.96 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $281.84 | Professional | None | $109.65 | $257.04 | $281.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $64.57 Typical High $128.82 | Professional | 52 · Reduced service | $54.95 | $64.57 | $128.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $26.30 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $26.30 | $51.29 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $97.72 Typical High $190.55 | Professional | 54 · Surgery only | $81.28 | $97.72 | $190.55 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $38.90 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $38.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $25.70 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $288.40 | Professional | None | $70.79 | $165.96 | $288.40 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,715.35 | Facility | None | $426.58 | $602.56 | $3,715.35 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $275.42 | Professional | None | $104.71 | $158.49 | $275.42 |
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 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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
$129
AK $437DC $97.72
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.