How much rates vary
Facilitymedian $513 · 10th to 90th $372 to $1,549Professionalmedian $129 · 10th to 90th $23 to $200
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 $100.00 Median $169.82 Typical High $4,897.79 | Facility | None | $100.00 | $169.82 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | None | $100.00 | $134.90 | $165.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $457.09 Median $512.86 Typical High $1,318.26 | Facility | None | $457.09 | $512.86 | $1,318.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $19.50 Median $109.65 Typical High $114.82 | Professional | None | $19.50 | $109.65 | $114.82 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $165.96 | Professional | None | $117.49 | $120.23 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $257.04 | Professional | None | $66.07 | $123.03 | $257.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $173.78 Median $398.11 Typical High $3,467.37 | Facility | None | $173.78 | $398.11 | $3,467.37 |
Health Alliance Plan Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $204.17 | Professional | None | $107.15 | $173.78 | $204.17 |
Priority Health Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $218.78 | Professional | None | $60.26 | $117.49 | $218.78 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $199.53 | Professional | None | $95.50 | $141.25 | $199.53 |
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 $50.12 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $50.12 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $19.95 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $75.86 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $16.60 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $60.26 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $60.26 | $89.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.99 Typical High $36.31 | Professional | 53 · Discontinued | $20.42 | $23.99 | $36.31 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $91.20 Typical High $134.90 | Professional | 54 · Surgery only | $77.62 | $91.20 | $134.90 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.20 Typical High $26.92 | Professional | 55 · Aftercare only | $15.49 | $18.20 | $26.92 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.02 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.23 | $12.02 | $18.20 |
Where Michigan sits
The same service costs 8.0 times more in New York than in North Dakota. 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 $2,762ND $346
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.