How much rates vary
Facilitymedian $245 · 10th to 90th $72 to $871Professionalmedian $66 · 10th to 90th $30 to $112
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 $39.81 Median $95.50 Typical High $4,897.79 | Facility | None | $39.81 | $95.50 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $74.13 Typical High $102.33 | Professional | None | $38.90 | $74.13 | $102.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $245.47 Median $251.19 Typical High $426.58 | Facility | None | $245.47 | $251.19 | $426.58 |
BCBS Michigan Setting Professional Modifier None Typical Low $6.92 Median $30.90 Typical High $95.50 | Professional | None | $6.92 | $30.90 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $58.88 Typical High $112.20 | Professional | None | $27.54 | $58.88 | $112.20 |
Health Alliance Plan Setting Facility Modifier None Typical Low $41.69 Median $141.25 Typical High $1,548.82 | Facility | None | $41.69 | $141.25 | $1,548.82 |
Health Alliance Plan Setting Professional Modifier None Typical Low $38.90 Median $89.13 Typical High $114.82 | Professional | None | $38.90 | $89.13 | $114.82 |
Priority Health Setting Professional Modifier None Typical Low $27.54 Median $54.95 Typical High $104.71 | Professional | None | $27.54 | $54.95 | $104.71 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $123.03 | Professional | None | $41.69 | $81.28 | $123.03 |
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 $19.50 Median $35.48 Typical High $47.86 | Professional | 52 · Reduced service | $19.50 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $14.13 Typical High $19.50 | Professional | 53 · Discontinued | $7.76 | $14.13 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $53.70 Typical High $72.44 | Professional | 54 · Surgery only | $29.51 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.72 Typical High $14.45 | Professional | 55 · Aftercare only | $5.89 | $10.72 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $7.08 Typical High $9.77 | Professional | 56 · Pre-op care only | $3.89 | $7.08 | $9.77 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.95 Typical High $46.77 | Professional | 52 · Reduced service | $19.50 | $19.95 | $46.77 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.94 Typical High $19.05 | Professional | 53 · Discontinued | $7.76 | $7.94 | $19.05 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $29.51 Typical High $70.79 | Professional | 54 · Surgery only | $28.84 | $29.51 | $70.79 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $14.13 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $14.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.98 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.89 | $3.98 | $9.33 |
Where Michigan sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 29th of 51
$83.18
WI $186NE $60.26
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.