How much rates vary
Facilitymedian $15,849 · 10th to 90th $1,413 to $33,884Professionalmedian $562 · 10th to 90th $479 to $646
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 $524.81 Median $4,897.79 Typical High $6,918.31 | Facility | None | $524.81 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
BCBS Michigan Setting Facility Modifier None Typical Low $14,125.38 Median $16,218.10 Typical High $41,686.94 | Facility | None | $14,125.38 | $16,218.10 | $41,686.94 |
BCBS Michigan Setting Professional Modifier None Typical Low $112.20 Median $562.34 Typical High $602.56 | Professional | None | $112.20 | $562.34 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $562.34 Typical High $741.31 | Professional | None | $354.81 | $562.34 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $602.56 Median $4,897.79 Typical High $9,332.54 | Facility | None | $602.56 | $4,897.79 | $9,332.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $645.65 | Professional | None | $489.78 | $588.84 | $645.65 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $467.74 Typical High $660.69 | Professional | None | $354.81 | $467.74 | $660.69 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,715.19 | Facility | None | $891.25 | $2,818.38 | $10,715.19 |
United Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $660.69 | Professional | None | $489.78 | $602.56 | $660.69 |
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 $263.03 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $54.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $295.12 | $302.00 | $302.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $87.10 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $60.26 |
Where Michigan sits
The same service costs 17.5 times more in Alaska 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
AK $22,553MT $1,291
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.