How much rates vary
Facilitymedian $1,023 · 10th to 90th $437 to $2,089Professionalmedian $339 · 10th to 90th $257 to $417
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 $338.84 Median $338.84 Typical High $6,918.31 | Facility | None | $338.84 | $338.84 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $354.81 | Professional | None | $281.84 | $338.84 | $354.81 |
BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,047.13 Typical High $1,819.70 | Facility | None | $1,023.29 | $1,047.13 | $1,819.70 |
BCBS Setting Professional Modifier None Typical Low $77.62 Median $257.04 Typical High $380.19 | Professional | None | $77.62 | $257.04 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $776.25 | Professional | None | $229.09 | $295.12 | $776.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $331.13 Median $912.01 Typical High $4,897.79 | Facility | None | $331.13 | $912.01 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $436.52 | Professional | None | $309.03 | $338.84 | $436.52 |
Priority Health Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $446.68 | Professional | None | $229.09 | $295.12 | $446.68 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | None | $316.23 | $354.81 | $457.09 |
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 $144.54 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $33.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $165.96 | $169.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | 53 · Discontinued | $66.07 | $66.07 | $67.61 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.88 |
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· 36th of 51
$355
AK $871UT $275
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.