How much rates vary
Facilitymedian $275 · 10th to 90th $126 to $661Professionalmedian $245 · 10th to 90th $174 to $295
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 $239.88 Median $239.88 Typical High $6,918.31 | Facility | None | $239.88 | $239.88 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | None | $208.93 | $245.47 | $245.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $275.42 Median $281.84 Typical High $489.78 | Facility | None | $275.42 | $281.84 | $489.78 |
BCBS Michigan Setting Professional Modifier None Typical Low $46.77 Median $263.03 Typical High $275.42 | Professional | None | $46.77 | $263.03 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $562.34 | Professional | None | $154.88 | $213.80 | $562.34 |
Health Alliance Plan Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $4,897.79 | Facility | None | $194.98 | $239.88 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $323.59 | Professional | None | $223.87 | $239.88 | $323.59 |
Priority Health Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $323.59 | Professional | None | $154.88 | $213.80 | $323.59 |
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 $234.42 Median $257.04 Typical High $338.84 | Professional | None | $234.42 | $257.04 | $338.84 |
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 $104.71 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $41.69 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $24.55 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where Michigan sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 30th of 51
$251
AK $631UT $195
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.