How much rates vary
Facilitymedian $1,698 · 10th to 90th $646 to $4,677Professionalmedian $166 · 10th to 90th $120 to $204
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 $158.49 Median $1,000.00 Typical High $6,918.31 | Facility | None | $158.49 | $1,000.00 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $173.78 | Professional | None | $125.89 | $158.49 | $173.78 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,951.21 | Facility | None | $1,698.24 | $1,737.80 | $2,951.21 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.90 Median $186.21 Typical High $186.21 | Professional | None | $38.90 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $426.58 | Professional | None | $107.15 | $144.54 | $426.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $199.53 Median $1,174.90 Typical High $5,754.40 | Facility | None | $199.53 | $1,174.90 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $218.78 | Professional | None | $147.91 | $158.49 | $218.78 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $380.19 | Professional | None | $107.15 | $144.54 | $380.19 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $218.78 | Professional | None | $151.36 | $169.82 | $218.78 |
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 $69.18 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $27.54 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $15.85 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $120.23 | Professional | 54 · Surgery only | $117.49 | $117.49 | $120.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Michigan sits
The same service costs 10.7 times more in Oklahoma 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· 41st of 51
$174
OK $1,413NY $132
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.