How much rates vary
Facilitymedian $3,162 · 10th to 90th $933 to $6,607Professionalmedian $372 · 10th to 90th $66 to $468
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 $363.08 Median $4,073.80 Typical High $5,754.40 | Facility | None | $363.08 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | None | $354.81 | $354.81 | $363.08 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $5,623.41 | Facility | None | $3,162.28 | $3,235.94 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $66.07 Median $389.05 Typical High $416.87 | Professional | None | $66.07 | $389.05 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $616.60 | Professional | None | $229.09 | $363.08 | $616.60 |
Health Alliance Plan Setting Facility Modifier None Typical Low $794.33 Median $1,659.59 Typical High $4,897.79 | Facility | None | $794.33 | $1,659.59 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $457.09 | Professional | None | $323.59 | $354.81 | $457.09 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $602.56 | Professional | None | $208.93 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $524.81 | Professional | None | $316.23 | $457.09 | $524.81 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 54 · Surgery only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $36.31 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $269.15 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Where Michigan sits
The same service costs 10.4 times more in Wyoming 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
WY $8,979MT $863
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.