How much rates vary
Facilitymedian $2,754 · 10th to 90th $550 to $4,898Professionalmedian $741 · 10th to 90th $550 to $1,148
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 $724.44 Median $2,041.74 Typical High $4,897.79 | Facility | None | $724.44 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | None | $645.65 | $741.31 | $741.31 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $4,897.79 | Facility | None | $2,754.23 | $2,818.38 | $4,897.79 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $1,148.15 Typical High $1,148.15 | Professional | None | $151.36 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,995.26 | Professional | None | $416.87 | $741.31 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,513.56 Typical High $4,897.79 | Facility | None | $977.24 | $1,513.56 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $891.25 | Professional | None | $575.44 | $707.95 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $1,778.28 | Professional | None | $416.87 | $660.69 | $1,778.28 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $5,248.07 | Facility | None | $426.58 | $602.56 | $5,248.07 |
United Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $954.99 | Professional | None | $645.65 | $758.58 | $954.99 |
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 $323.59 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in New York. 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· 38th of 51
$741
AK $2,239NY $575
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.