How much rates vary
Facilitymedian $550 · 10th to 90th $372 to $1,778Professionalmedian $490 · 10th to 90th $324 to $759
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 $478.63 Median $2,041.74 Typical High $4,897.79 | Facility | None | $478.63 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $489.78 | Professional | None | $416.87 | $489.78 | $489.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $954.99 | Facility | None | $549.54 | $562.34 | $954.99 |
BCBS Michigan Setting Professional Modifier None Typical Low $85.11 Median $758.58 Typical High $758.58 | Professional | None | $85.11 | $758.58 | $758.58 |
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 $275.42 Median $436.52 Typical High $1,148.15 | Professional | None | $275.42 | $436.52 | $1,148.15 |
Health Alliance Plan Setting Facility Modifier None Typical Low $380.19 Median $1,000.00 Typical High $4,897.79 | Facility | None | $380.19 | $1,000.00 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $575.44 | Professional | None | $380.19 | $467.74 | $575.44 |
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 $275.42 Median $436.52 Typical High $524.81 | Professional | None | $275.42 | $436.52 | $524.81 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $3,630.78 | Facility | None | $288.40 | $426.58 | $3,630.78 |
United Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $616.60 | Professional | None | $426.58 | $501.19 | $616.60 |
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 $208.93 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $48.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Where Michigan sits
The same service costs 5.2 times more in Alaska than in Delaware. 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
AK $4,868DE $935
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.