How much rates vary
Facilitymedian $708 · 10th to 90th $151 to $1,905Professionalmedian $100 · 10th to 90th $69 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 $100.00 Median $104.71 Typical High $4,897.79 | Facility | None | $100.00 | $104.71 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | None | $100.00 | $100.00 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,230.27 | Facility | None | $707.95 | $724.44 | $1,230.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $19.05 Median $112.20 Typical High $169.82 | Professional | None | $19.05 | $112.20 | $169.82 |
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 $57.54 Median $93.33 Typical High $186.21 | Professional | None | $57.54 | $93.33 | $186.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $102.33 Median $512.86 Typical High $2,691.53 | Facility | None | $102.33 | $512.86 | $2,691.53 |
Health Alliance Plan Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $114.82 | Professional | None | $81.28 | $102.33 | $114.82 |
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 $57.54 Median $83.18 Typical High $131.83 | Professional | None | $57.54 | $83.18 | $131.83 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
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 $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 54 · Surgery only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $50.12 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.89 | $20.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 54 · Surgery only | $75.86 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $15.85 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $10.47 |
Where Michigan sits
The same service costs 12.2 times more in Connecticut than in Montana. 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.
Physician feeFacility fee
CT $2,815MT $231
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.