How much rates vary
Facilitymedian $2,951 · 10th to 90th $525 to $7,413Professionalmedian $398 · 10th to 90th $87 to $589
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 $398.11 Median $407.38 Typical High $4,897.79 | Facility | None | $398.11 | $407.38 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $467.74 | Professional | None | $316.23 | $398.11 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,951.21 Median $3,019.95 Typical High $5,128.61 | Facility | None | $2,951.21 | $3,019.95 | $5,128.61 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $407.38 Typical High $616.60 | Professional | None | $83.18 | $407.38 | $616.60 |
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 $223.87 Median $407.38 Typical High $1,071.52 | Professional | None | $223.87 | $407.38 | $1,071.52 |
Health Alliance Plan Setting Facility Modifier None Typical Low $416.87 Median $3,981.07 Typical High $7,943.28 | Facility | None | $416.87 | $3,981.07 | $7,943.28 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $501.19 | Professional | None | $316.23 | $380.19 | $501.19 |
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 $223.87 Median $371.54 Typical High $954.99 | Professional | None | $223.87 | $371.54 | $954.99 |
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 $354.81 Median $407.38 Typical High $512.86 | Professional | None | $354.81 | $407.38 | $512.86 |
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 $173.78 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $257.04 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $51.29 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $34.67 | $39.81 | $39.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where Michigan sits
The same service costs 6.4 times more in Oklahoma 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
OK $5,884MT $914
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.