How much rates vary
Facilitymedian $1,820 · 10th to 90th $490 to $3,388Professionalmedian $589 · 10th to 90th $148 to $724
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 $575.44 Median $575.44 Typical High $6,918.31 | Facility | None | $575.44 | $575.44 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $616.60 | Professional | None | $457.09 | $588.84 | $616.60 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $3,162.28 | Facility | None | $1,819.70 | $1,862.09 | $3,162.28 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $630.96 Typical High $707.95 | Professional | None | $112.20 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $1,348.96 | Professional | None | $389.05 | $501.19 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $575.44 Median $1,584.89 Typical High $4,897.79 | Facility | None | $575.44 | $1,584.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $758.58 | Professional | None | $512.86 | $575.44 | $758.58 |
Priority Health Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $776.25 | Professional | None | $389.05 | $524.81 | $776.25 |
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 $549.54 Median $616.60 Typical High $812.83 | Professional | None | $549.54 | $616.60 | $812.83 |
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 $251.19 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $251.19 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $58.88 | $58.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Where Michigan sits
The same service costs 3.4 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· 29th of 51
$617
AK $1,514UT $447
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.