How much rates vary
Facilitymedian $417 · 10th to 90th $339 to $1,230Professionalmedian $145 · 10th to 90th $102 to $166
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 $144.54 Median $2,041.74 Typical High $4,897.79 | Facility | None | $144.54 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | None | $120.23 | $151.36 | $151.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $645.65 | Facility | None | $371.54 | $380.19 | $645.65 |
BCBS Michigan Setting Professional Modifier None Typical Low $34.67 Median $162.18 Typical High $162.18 | Professional | None | $34.67 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $398.11 | Professional | None | $87.10 | $128.82 | $398.11 |
Health Alliance Plan Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $4,897.79 | Facility | None | $316.23 | $426.58 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $186.21 | Professional | None | $125.89 | $144.54 | $186.21 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $354.81 | Professional | None | $87.10 | $120.23 | $354.81 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $173.78 | Professional | None | $104.71 | $134.90 | $173.78 |
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 $60.26 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 54 · Surgery only | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $15.14 | $15.14 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.18 | $28.84 | $28.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $104.71 | $109.65 | $109.65 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $21.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $14.45 |
Where Michigan sits
The same service costs 4.4 times more in Alaska 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· 36th of 51
$148
AK $479NY $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.