How much rates vary
Facilitymedian $151 · 10th to 90th $56 to $708Professionalmedian $52 · 10th to 90th $25 to $74
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 $33.11 Median $56.23 Typical High $2,041.74 | Facility | None | $33.11 | $56.23 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $61.66 | Professional | None | $33.11 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $20.89 Typical High $28.18 | Professional | 52 · Reduced service | $16.60 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.32 Typical High $11.48 | Professional | 53 · Discontinued | $6.61 | $8.32 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $30.90 Typical High $42.66 | Professional | 54 · Surgery only | $24.55 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.17 Typical High $8.51 | Professional | 55 · Aftercare only | $4.90 | $6.17 | $8.51 |
BCBS Michigan Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $416.87 | Facility | None | $131.83 | $169.82 | $416.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $5.50 Median $25.70 Typical High $56.23 | Professional | None | $5.50 | $25.70 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $74.13 | Professional | None | $23.44 | $39.81 | $74.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $33.11 Median $131.83 Typical High $3,467.37 | Facility | None | $33.11 | $131.83 | $3,467.37 |
Health Alliance Plan Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $77.62 | Professional | None | $32.36 | $56.23 | $77.62 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $28.18 | Professional | 52 · Reduced service | $16.22 | $16.22 | $28.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.61 Typical High $11.22 | Professional | 53 · Discontinued | $6.46 | $6.61 | $11.22 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $24.55 Typical High $41.69 | Professional | 54 · Surgery only | $24.55 | $24.55 | $41.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $8.32 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $8.32 |
Priority Health Setting Professional Modifier None Typical Low $23.44 Median $36.31 Typical High $67.61 | Professional | None | $23.44 | $36.31 | $67.61 |
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 $32.36 Median $51.29 Typical High $85.11 | Professional | None | $32.36 | $51.29 | $85.11 |
2 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 56 · Pre-op care only Typical Low $3.31 Median $4.17 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.31 | $4.17 | $5.75 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.07 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.24 | $4.07 | $5.62 |
Where Michigan sits
The same service costs 3.4 times more in Wisconsin 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· 25th of 51
$56.23
WI $132UT $38.90
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.