How much rates vary
Facilitymedian $457 · 10th to 90th $398 to $1,259Professionalmedian $138 · 10th to 90th $30 to $158
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 $138.04 Median $138.04 Typical High $6,918.31 | Facility | None | $138.04 | $138.04 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | None | $138.04 | $141.25 | $141.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $398.11 Median $407.38 Typical High $707.95 | Facility | None | $398.11 | $407.38 | $707.95 |
BCBS Michigan Setting Professional Modifier None Typical Low $25.12 Median $91.20 Typical High $158.49 | Professional | None | $25.12 | $91.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $208.93 | Professional | None | $91.20 | $123.03 | $208.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $138.04 Median $331.13 Typical High $4,897.79 | Facility | None | $138.04 | $331.13 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $158.49 | Professional | None | $112.20 | $138.04 | $158.49 |
Priority Health Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $208.93 | Professional | None | $89.13 | $120.23 | $208.93 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $169.82 | Professional | None | $125.89 | $158.49 | $169.82 |
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 $69.18 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $27.54 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.80 | $14.13 | $14.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 54 · Surgery only | $104.71 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Michigan sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 25th of 51
$138
AK $427NJ $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.