How much rates vary
Facilitymedian $155 · 10th to 90th $107 to $1,230Professionalmedian $100 · 10th to 90th $56 to $182
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 $56.23 Median $102.33 Typical High $4,897.79 | Facility | None | $56.23 | $102.33 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $104.71 | Professional | None | $56.23 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $28.18 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $11.22 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $60.26 Typical High $75.86 | Professional | 54 · Surgery only | $42.66 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $8.51 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.62 | $8.13 | $10.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $190.55 | Facility | None | $107.15 | $109.65 | $190.55 |
BCBS Michigan Setting Professional Modifier None Typical Low $11.48 Median $89.13 Typical High $89.13 | Professional | None | $11.48 | $89.13 | $89.13 |
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 $38.90 Median $89.13 Typical High $186.21 | Professional | None | $38.90 | $89.13 | $186.21 |
Health Alliance Plan Setting Facility Modifier None Typical Low $104.71 Median $354.81 Typical High $4,897.79 | Facility | None | $104.71 | $354.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $57.54 Median $141.25 Typical High $186.21 | Professional | None | $57.54 | $141.25 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $39.81 Typical High $52.48 | Professional | 52 · Reduced service | $27.54 | $39.81 | $52.48 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.85 Typical High $20.89 | Professional | 53 · Discontinued | $11.22 | $15.85 | $20.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $41.69 | $58.88 | $79.43 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $8.32 | $12.02 | $15.85 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.94 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.62 | $7.94 | $10.47 |
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 $33.11 Median $74.13 Typical High $173.78 | Professional | None | $33.11 | $74.13 | $173.78 |
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 $54.95 Median $102.33 Typical High $165.96 | Professional | None | $54.95 | $102.33 | $165.96 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $128.82 Typical High $186.21 | Professional | 50 · Both sides | $95.50 | $128.82 | $186.21 |
Where Michigan sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 20th of 51
$102
AK $191VA $60.26
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.