How much rates vary
Facilitymedian $309 · 10th to 90th $91 to $676Professionalmedian $110 · 10th to 90th $65 to $158
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 $69.18 Median $144.54 Typical High $2,884.03 | Facility | None | $69.18 | $144.54 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $151.36 | Professional | None | $67.61 | $100.00 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $549.54 | Facility | None | $309.03 | $316.23 | $549.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $14.79 Median $74.13 Typical High $109.65 | Professional | None | $14.79 | $74.13 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $138.04 | Professional | None | $97.72 | $102.33 | $138.04 |
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 $47.86 Median $95.50 Typical High $186.21 | Professional | None | $47.86 | $95.50 | $186.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $120.23 Median $288.40 Typical High $676.08 | Facility | None | $120.23 | $288.40 | $676.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $165.96 | Professional | None | $67.61 | $138.04 | $165.96 |
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 $39.81 Median $93.33 Typical High $177.83 | Professional | None | $39.81 | $93.33 | $177.83 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $151.36 | Professional | None | $61.66 | $100.00 | $151.36 |
11 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 $33.88 Median $48.98 Typical High $72.44 | Professional | 52 · Reduced service | $33.88 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.50 Typical High $28.84 | Professional | 53 · Discontinued | $13.49 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $74.13 Typical High $107.15 | Professional | 54 · Surgery only | $51.29 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $10.23 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.77 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.76 | $9.77 | $14.45 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $147.91 Typical High $380.19 | Professional | 50 · Both sides | $117.49 | $147.91 | $380.19 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $48.98 Typical High $72.44 | Professional | 52 · Reduced service | $32.36 | $48.98 | $72.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.50 Typical High $28.84 | Professional | 53 · Discontinued | $12.88 | $19.50 | $28.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $72.44 Typical High $107.15 | Professional | 54 · Surgery only | $47.86 | $72.44 | $107.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.45 Typical High $21.88 | Professional | 55 · Aftercare only | $9.77 | $14.45 | $21.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.77 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.46 | $9.77 | $14.45 |
Where Michigan sits
The same service costs 3.4 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· 23rd of 51
$115
AK $234KY $69.18
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.