How much rates vary
Facilitymedian $309 · 10th to 90th $89 to $933Professionalmedian $98 · 10th to 90th $63 to $129
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 $70.79 Median $100.00 Typical High $2,884.03 | Facility | None | $70.79 | $100.00 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $104.71 | Professional | None | $69.18 | $93.33 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $44.67 Median $75.86 Typical High $128.82 | Professional | None | $44.67 | $75.86 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $95.50 | Professional | None | $67.61 | $70.79 | $95.50 |
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 $43.65 Median $81.28 Typical High $169.82 | Professional | None | $43.65 | $81.28 | $169.82 |
Health Alliance Plan Setting Facility Modifier None Typical Low $74.13 Median $208.93 Typical High $1,698.24 | Facility | None | $74.13 | $208.93 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
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 $41.69 Median $72.44 Typical High $141.25 | Professional | None | $41.69 | $72.44 | $141.25 |
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 $64.57 Median $87.10 Typical High $125.89 | Professional | None | $64.57 | $87.10 | $125.89 |
12 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 $34.67 Median $37.15 Typical High $50.12 | Professional | 52 · Reduced service | $34.67 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $19.95 | Professional | 53 · Discontinued | $13.80 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $56.23 Typical High $74.13 | Professional | 54 · Surgery only | $52.48 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $10.00 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $194.98 Typical High $194.98 | Professional | 50 · Both sides | $114.82 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $177.83 Typical High $354.81 | Professional | 50 · Both sides | $66.07 | $177.83 | $354.81 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $37.15 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $37.15 | $48.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $19.95 | Professional | 53 · Discontinued | $13.80 | $14.79 | $19.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $56.23 Typical High $74.13 | Professional | 54 · Surgery only | $51.29 | $56.23 | $74.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $14.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $9.77 |
Where Michigan sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 19th of 51
$97.72
AK $214TX $67.61
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.