How much rates vary
Facilitymedian $10,965 · 10th to 90th $794 to $17,378Professionalmedian $513 · 10th to 90th $295 to $794
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 $776.25 Median $2,041.74 Typical High $4,897.79 | Facility | None | $776.25 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $10,964.78 Median $11,220.18 Typical High $19,498.45 | Facility | None | $10,964.78 | $11,220.18 | $19,498.45 |
BCBS Michigan Setting Professional Modifier None Typical Low $75.86 Median $380.19 Typical High $724.44 | Professional | None | $75.86 | $380.19 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,096.48 | Professional | None | $467.74 | $660.69 | $1,096.48 |
Health Alliance Plan Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $4,897.79 | Facility | None | $794.33 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $426.58 Median $776.25 Typical High $812.83 | Professional | None | $426.58 | $776.25 | $812.83 |
Priority Health Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Priority Health Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $851.14 | Professional | None | $457.09 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $8,709.64 | Facility | None | $645.65 | $1,621.81 | $8,709.64 |
United Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $416.87 | Professional | None | $309.03 | $354.81 | $416.87 |
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 $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Where Michigan sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 32nd of 51
$617
AK $2,455KY $245
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.