How much rates vary
Facilitymedian $182 · 10th to 90th $129 to $1,230Professionalmedian $110 · 10th to 90th $71 to $178
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 $72.44 Median $112.20 Typical High $4,897.79 | Facility | None | $72.44 | $112.20 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $114.82 | Professional | None | $72.44 | $100.00 | $114.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $223.87 | Facility | None | $128.82 | $131.83 | $223.87 |
BCBS Michigan Setting Professional Modifier None Typical Low $12.59 Median $104.71 Typical High $147.91 | Professional | None | $12.59 | $104.71 | $147.91 |
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 $48.98 Median $87.10 Typical High $186.21 | Professional | None | $48.98 | $87.10 | $186.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $74.13 Median $154.88 Typical High $3,467.37 | Facility | None | $74.13 | $154.88 | $3,467.37 |
Health Alliance Plan Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $181.97 | Professional | None | $74.13 | $138.04 | $181.97 |
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 $75.86 Typical High $147.91 | Professional | None | $41.69 | $75.86 | $147.91 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $173.78 | Professional | None | $70.79 | $93.33 | $173.78 |
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 $36.31 Median $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $36.31 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $14.45 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $63.10 Typical High $81.28 | Professional | 54 · Surgery only | $53.70 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $16.22 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.24 | $8.51 | $10.96 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $223.87 Typical High $223.87 | Professional | 50 · Both sides | $120.23 | $223.87 | $223.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $38.02 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $38.02 | $56.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.14 Typical High $22.91 | Professional | 53 · Discontinued | $14.13 | $15.14 | $22.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $57.54 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $57.54 | $85.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.48 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $11.48 | $16.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $11.48 |
Where Michigan sits
The same service costs 3.2 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· 18th of 51
$112
AK $224KY $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.