How much rates vary
Facilitymedian $2,754 · 10th to 90th $661 to $5,012Professionalmedian $457 · 10th to 90th $302 to $724
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 $457.09 Median $2,041.74 Typical High $4,897.79 | Facility | None | $457.09 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | None | $407.38 | $467.74 | $467.74 |
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 $95.50 Median $691.83 Typical High $724.44 | Professional | None | $95.50 | $691.83 | $724.44 |
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 $263.03 Median $467.74 Typical High $1,258.93 | Professional | None | $263.03 | $467.74 | $1,258.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $912.01 Median $1,479.11 Typical High $4,897.79 | Facility | None | $912.01 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $562.34 | Professional | None | $363.08 | $446.68 | $562.34 |
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 $263.03 Median $416.87 Typical High $1,122.02 | Professional | None | $263.03 | $416.87 | $1,122.02 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,025.60 | Facility | None | $602.56 | $1,230.27 | $6,025.60 |
United Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $602.56 | Professional | None | $407.38 | $478.63 | $602.56 |
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 $204.17 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $354.81 | Professional | 54 · Surgery only | $302.00 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $46.77 | $46.77 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $338.84 | $338.84 | $338.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Where Michigan sits
The same service costs 7.8 times more in Oklahoma 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· 39th of 51
$468
OK $2,630NY $339
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.