How much rates vary
Facilitymedian $263 · 10th to 90th $126 to $617Professionalmedian $132 · 10th to 90th $33 to $151
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 $134.90 Median $134.90 Typical High $6,918.31 | Facility | None | $134.90 | $134.90 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $134.90 | Professional | None | $114.82 | $134.90 | $134.90 |
BCBS Michigan Setting Facility Modifier None Typical Low $263.03 Median $269.15 Typical High $457.09 | Facility | None | $263.03 | $269.15 | $457.09 |
BCBS Michigan Setting Professional Modifier None Typical Low $25.70 Median $89.13 Typical High $151.36 | Professional | None | $25.70 | $89.13 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $316.23 | Professional | None | $91.20 | $112.20 | $316.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $4,897.79 | Facility | None | $151.36 | $151.36 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $151.36 | Professional | None | $97.72 | $128.82 | $151.36 |
Priority Health Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $213.80 | Professional | None | $91.20 | $112.20 | $213.80 |
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 $114.82 Median $131.83 Typical High $169.82 | Professional | None | $114.82 | $131.83 | $169.82 |
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 $57.54 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $13.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 54 · Surgery only | $100.00 | $100.00 | $102.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $20.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Where Michigan sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$135
AK $355TX $110
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.