How much rates vary
Facilitymedian $380 · 10th to 90th $288 to $1,259Professionalmedian $178 · 10th to 90th $148 to $871
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 $173.78 Median $467.74 Typical High $4,897.79 | Facility | None | $173.78 | $467.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $199.53 | Professional | None | $141.25 | $190.55 | $199.53 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $575.44 | Facility | None | $309.03 | $316.23 | $575.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $831.76 Typical High $870.96 | Professional | None | $147.91 | $831.76 | $870.96 |
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 $112.20 Median $199.53 Typical High $467.74 | Professional | None | $112.20 | $199.53 | $467.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $194.98 Median $416.87 Typical High $2,884.03 | Facility | None | $194.98 | $416.87 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $251.19 | Professional | None | $151.36 | $177.83 | $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 $112.20 Median $158.49 Typical High $363.08 | Professional | None | $112.20 | $158.49 | $363.08 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $229.09 | Professional | None | $141.25 | $169.82 | $229.09 |
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 $79.43 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $31.62 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $23.99 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $19.05 | $19.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $87.10 | $89.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 54 · Surgery only | $128.82 | $134.90 | $134.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.78 Typical High $17.78 | Professional | 56 · Pre-op care only | $17.38 | $17.78 | $17.78 |
Where Michigan sits
The same service costs 4.3 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· 45th of 51
$186
AK $603NY $141
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.