How much rates vary
Facilitymedian $1,514 · 10th to 90th $708 to $4,074Professionalmedian $447 · 10th to 90th $295 to $676
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 $446.68 Median $4,073.80 Typical High $5,754.40 | Facility | None | $446.68 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | None | $389.05 | $457.09 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,691.53 | Facility | None | $1,513.56 | $1,548.82 | $2,691.53 |
BCBS Michigan Setting Professional Modifier None Typical Low $79.43 Median $446.68 Typical High $707.95 | Professional | None | $79.43 | $446.68 | $707.95 |
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 $251.19 Median $457.09 Typical High $1,071.52 | Professional | None | $251.19 | $457.09 | $1,071.52 |
Health Alliance Plan Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $4,897.79 | Facility | None | $891.25 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $537.03 | Professional | None | $354.81 | $436.52 | $537.03 |
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 $251.19 Median $416.87 Typical High $891.25 | Professional | None | $251.19 | $416.87 | $891.25 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $575.44 | Professional | None | $398.11 | $467.74 | $575.44 |
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 $194.98 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $45.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Where Michigan sits
The same service costs 4.7 times more in Alaska 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· 43rd of 51
$457
AK $1,622NY $347
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.