How much rates vary
Facilitymedian $776 · 10th to 90th $89 to $4,169Professionalmedian $78 · 10th to 90th $50 to $138
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 $60.26 Median $128.82 Typical High $2,884.03 | Facility | None | $60.26 | $128.82 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $138.04 | Professional | None | $60.26 | $83.18 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $22.91 Median $79.43 Typical High $141.25 | Professional | None | $22.91 | $79.43 | $141.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $776.25 Median $794.33 Typical High $1,348.96 | Facility | None | $776.25 | $794.33 | $1,348.96 |
BCBS Michigan Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $128.82 | Professional | None | $31.62 | $53.70 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $165.96 | Professional | None | $46.77 | $81.28 | $165.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $89.13 Median $1,412.54 Typical High $6,309.57 | Facility | None | $89.13 | $1,412.54 | $6,309.57 |
Health Alliance Plan Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $141.25 | Professional | None | $60.26 | $85.11 | $141.25 |
Priority Health Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $151.36 | Professional | None | $46.77 | $75.86 | $151.36 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $117.49 | Professional | None | $63.10 | $85.11 | $117.49 |
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 $30.20 Median $44.67 Typical High $66.07 | Professional | 52 · Reduced service | $30.20 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.78 Typical High $26.30 | Professional | 53 · Discontinued | $12.02 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $67.61 Typical High $100.00 | Professional | 54 · Surgery only | $45.71 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.49 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $13.49 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $13.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $51.29 Typical High $66.07 | Professional | 52 · Reduced service | $30.20 | $51.29 | $66.07 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $12.02 | $19.50 | $26.30 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $46.77 Typical High $100.00 | Professional | 54 · Surgery only | $44.67 | $46.77 | $100.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $19.95 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $19.95 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $13.18 |
Where Michigan sits
The same service costs 3.2 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· 48th of 51
$85.11
AK $251NY $77.62
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.