How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,570Professionalmedian $776 · 10th to 90th $479 to $1,023
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 $831.76 Typical High $831.76 | Professional | None | $776.25 | $831.76 | $831.76 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,288.25 | $2,187.76 |
BCBS Michigan Setting Professional Modifier None Typical Low $162.18 Median $851.14 Typical High $851.14 | Professional | None | $162.18 | $851.14 | $851.14 |
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 $478.63 Median $588.84 Typical High $1,174.90 | Professional | None | $478.63 | $588.84 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,897.79 | Facility | None | $1,071.52 | $1,698.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $912.01 | Professional | None | $645.65 | $758.58 | $912.01 |
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 $478.63 Median $575.44 Typical High $851.14 | Professional | None | $478.63 | $575.44 | $851.14 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,235.94 | Facility | None | $426.58 | $602.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,513.56 | Professional | None | $489.78 | $575.44 | $1,513.56 |
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 $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $389.05 | $389.05 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $151.36 | $158.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $588.84 | $588.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $79.43 |
Where Michigan sits
The same service costs 4.5 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· 29th of 51
$794
AK $2,344KY $525
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.