How much rates vary
Facilitymedian $120 · 10th to 90th $95 to $479Professionalmedian $71 · 10th to 90th $40 to $100
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 $52.48 Median $93.33 Typical High $4,897.79 | Facility | None | $52.48 | $93.33 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $95.50 | Professional | None | $52.48 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $34.67 Typical High $47.86 | Professional | 52 · Reduced service | $26.30 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $13.80 Typical High $19.05 | Professional | 53 · Discontinued | $10.47 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $52.48 Typical High $72.44 | Professional | 54 · Surgery only | $38.90 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.47 Typical High $14.45 | Professional | 55 · Aftercare only | $7.76 | $10.47 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.92 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.25 | $6.92 | $9.55 |
BCBS Michigan Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $165.96 | Facility | None | $95.50 | $97.72 | $165.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $56.23 | Professional | None | $33.11 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $66.07 Typical High $112.20 | Professional | None | $37.15 | $66.07 | $112.20 |
Health Alliance Plan Setting Facility Modifier None Typical Low $51.29 Median $190.55 Typical High $4,897.79 | Facility | None | $51.29 | $190.55 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $107.15 | Professional | None | $51.29 | $87.10 | $107.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $26.30 Typical High $46.77 | Professional | 52 · Reduced service | $25.70 | $26.30 | $46.77 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.47 Typical High $18.62 | Professional | 53 · Discontinued | $10.23 | $10.47 | $18.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $38.90 | $69.18 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $13.80 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $13.80 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.25 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.13 | $5.25 | $9.33 |
Priority Health Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $102.33 | Professional | None | $37.15 | $54.95 | $102.33 |
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 $48.98 Median $75.86 Typical High $104.71 | Professional | None | $48.98 | $75.86 | $104.71 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 59 · Distinct service | $74.13 | $74.13 | $74.13 |
Where Michigan sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 37th of 51
$75.86
WI $209KY $61.66
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.