How much rates vary
Facilitymedian $977 · 10th to 90th $513 to $2,042Professionalmedian $347 · 10th to 90th $204 to $490
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 $331.13 Median $2,041.74 Typical High $4,897.79 | Facility | None | $331.13 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
BCBS Michigan Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,698.24 | Facility | None | $977.24 | $977.24 | $1,698.24 |
BCBS Michigan Setting Professional Modifier None Typical Low $64.57 Median $288.40 Typical High $346.74 | Professional | None | $64.57 | $288.40 | $346.74 |
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 $190.55 Median $309.03 Typical High $575.44 | Professional | None | $190.55 | $309.03 | $575.44 |
Health Alliance Plan Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $4,897.79 | Facility | None | $549.54 | $831.76 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $416.87 | Professional | None | $316.23 | $346.74 | $416.87 |
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 $190.55 Median $309.03 Typical High $407.38 | Professional | None | $190.55 | $309.03 | $407.38 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $575.44 | Professional | None | $288.40 | $331.13 | $575.44 |
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 $165.96 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $34.67 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $165.96 | $173.78 | $173.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $251.19 | $257.04 | $257.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $51.29 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $34.67 |
Where Michigan sits
The same service costs 6.0 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,737MT $787
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.