How much rates vary
Facilitymedian $1,479 · 10th to 90th $589 to $3,388Professionalmedian $126 · 10th to 90th $83 to $148
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 $125.89 Median $2,041.74 Typical High $4,897.79 | Facility | None | $125.89 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $128.82 | Professional | None | $107.15 | $128.82 | $128.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $141.25 | Professional | None | $83.18 | $131.83 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $346.74 | Professional | None | $70.79 | $128.82 | $346.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $257.04 Median $1,174.90 Typical High $4,897.79 | Facility | None | $257.04 | $1,174.90 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $151.36 | Professional | None | $97.72 | $123.03 | $151.36 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $302.00 | Professional | None | $70.79 | $114.82 | $302.00 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $169.82 | Professional | None | $112.20 | $131.83 | $169.82 |
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 $54.95 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $54.95 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $21.88 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $83.18 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.60 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.96 | $12.88 | $12.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $91.20 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where Michigan sits
The same service costs 15.6 times more in Colorado 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
CO $4,608MT $296
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.