How much rates vary
Facilitymedian $4,266 · 10th to 90th $589 to $7,586Professionalmedian $513 · 10th to 90th $331 to $692
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 $512.86 Median $524.81 Typical High $4,897.79 | Facility | None | $512.86 | $524.81 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $562.34 | Professional | None | $489.78 | $512.86 | $562.34 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,365.16 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $107.15 Median $537.03 Typical High $575.44 | Professional | None | $107.15 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $1,380.38 | Professional | None | $288.40 | $524.81 | $1,380.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $524.81 Median $3,467.37 Typical High $8,709.64 | Facility | None | $524.81 | $3,467.37 | $8,709.64 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | None | $467.74 | $512.86 | $676.08 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $1,230.27 | Professional | None | $288.40 | $524.81 | $1,230.27 |
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 $467.74 Median $602.56 Typical High $741.31 | Professional | None | $467.74 | $602.56 | $741.31 |
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 $223.87 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $371.54 | $371.54 | $371.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where Michigan sits
The same service costs 6.4 times more in Alaska than in Montana. 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 $7,574MT $1,191
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.