How much rates vary
Facilitymedian $631 · 10th to 90th $372 to $1,585Professionalmedian $676 · 10th to 90th $145 to $1,023
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 $691.83 Median $2,041.74 Typical High $4,897.79 | Facility | None | $691.83 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $707.95 | Professional | None | $602.56 | $691.83 | $707.95 |
BCBS Michigan Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $1,096.48 | Facility | None | $630.96 | $645.65 | $1,096.48 |
BCBS Michigan Setting Professional Modifier None Typical Low $123.03 Median $446.68 Typical High $1,071.52 | Professional | None | $123.03 | $446.68 | $1,071.52 |
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 $371.54 Median $630.96 Typical High $1,659.59 | Professional | None | $371.54 | $630.96 | $1,659.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $380.19 Median $1,412.54 Typical High $4,897.79 | Facility | None | $380.19 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $831.76 | Professional | None | $537.03 | $676.08 | $831.76 |
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 $371.54 Median $575.44 Typical High $741.31 | Professional | None | $371.54 | $575.44 | $741.31 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $891.25 | Professional | None | $602.56 | $724.44 | $891.25 |
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 $302.00 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $70.79 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $134.90 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Where Michigan sits
The same service costs 4.0 times more in Alaska than in Utah. 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· 35th of 51
$676
AK $2,089UT $525
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.