How much rates vary
Facilitymedian $741 · 10th to 90th $437 to $1,549Professionalmedian $257 · 10th to 90th $69 to $339
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 $275.42 Median $281.84 Typical High $6,918.31 | Facility | None | $275.42 | $281.84 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | None | $275.42 | $295.12 | $295.12 |
BCBS Michigan Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,288.25 | Facility | None | $741.31 | $741.31 | $1,288.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $53.70 Median $223.87 Typical High $346.74 | Professional | None | $53.70 | $223.87 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $416.87 | Professional | None | $173.78 | $251.19 | $416.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $269.15 Median $602.56 Typical High $4,897.79 | Facility | None | $269.15 | $602.56 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $295.12 | Professional | None | $208.93 | $269.15 | $295.12 |
Priority Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $302.00 | Professional | None | $173.78 | $251.19 | $302.00 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $263.03 | Professional | None | $218.78 | $245.47 | $263.03 |
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 $138.04 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $208.93 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $29.51 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $53.70 | $56.23 | $56.23 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $40.74 | $41.69 | $41.69 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $28.18 |
Where Michigan sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 30th of 51
$257
AK $832UT $162
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.