How much rates vary
Facilitymedian $1,230 · 10th to 90th $479 to $3,090Professionalmedian $148 · 10th to 90th $89 to $251
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 $123.03 Median $186.21 Typical High $4,897.79 | Facility | None | $123.03 | $186.21 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $208.93 | Professional | None | $123.03 | $158.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | None | $70.79 | $77.62 | $89.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,122.02 | $1,949.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.30 Median $128.82 Typical High $251.19 | Professional | None | $26.30 | $128.82 | $251.19 |
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 $89.13 Median $138.04 Typical High $346.74 | Professional | None | $89.13 | $138.04 | $346.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $186.21 Median $1,412.54 Typical High $4,897.79 | Facility | None | $186.21 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $251.19 | Professional | None | $123.03 | $186.21 | $251.19 |
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 $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
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 $117.49 Median $173.78 Typical High $251.19 | Professional | None | $117.49 | $173.78 | $251.19 |
11 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 $61.66 Median $69.18 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $24.55 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $138.04 | Professional | 54 · Surgery only | $91.20 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $18.62 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | GC · Resident with teaching physician | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $63.10 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $63.10 | $93.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $24.55 | $27.54 | $37.15 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $93.33 | $102.33 | $141.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $28.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $18.62 |
Where Michigan sits
The same service costs 12.7 times more in Colorado than in North Dakota. 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 $4,551ND $359
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.