How much rates vary
Facilitymedian $708 · 10th to 90th $209 to $2,239Professionalmedian $170 · 10th to 90th $98 to $224
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 $208.93 Typical High $2,884.03 | Facility | None | $144.54 | $208.93 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $223.87 | Professional | None | $144.54 | $165.96 | $223.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $2,238.72 | Facility | None | $707.95 | $912.01 | $2,238.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.84 Median $144.54 Typical High $199.53 | Professional | None | $28.84 | $144.54 | $199.53 |
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 $93.33 Median $154.88 Typical High $302.00 | Professional | None | $93.33 | $154.88 | $302.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $151.36 Median $512.86 Typical High $3,630.78 | Facility | None | $151.36 | $512.86 | $3,630.78 |
Health Alliance Plan Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $239.88 | Professional | None | $147.91 | $208.93 | $239.88 |
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 $83.18 Median $154.88 Typical High $245.47 | Professional | None | $83.18 | $154.88 | $245.47 |
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 $123.03 Median $165.96 Typical High $213.80 | Professional | None | $123.03 | $165.96 | $213.80 |
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 $72.44 Median $74.13 Typical High $104.71 | Professional | 52 · Reduced service | $72.44 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $42.66 | Professional | 53 · Discontinued | $28.84 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $112.20 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $20.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $74.13 | $109.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $43.65 | Professional | 53 · Discontinued | $28.84 | $30.20 | $43.65 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $112.20 | $165.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $33.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $21.88 |
Where Michigan sits
The same service costs 6.3 times more in New York 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
NY $2,712MT $427
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.