How much rates vary
Facilitymedian $741 · 10th to 90th $195 to $1,549Professionalmedian $162 · 10th to 90th $123 to $224
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 $138.04 Median $199.53 Typical High $4,897.79 | Facility | None | $138.04 | $199.53 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $208.93 | Professional | None | $134.90 | $151.36 | $208.93 |
BCBS Michigan Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $1,288.25 | Facility | None | $741.31 | $758.58 | $1,288.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $25.12 Median $158.49 Typical High $223.87 | Professional | None | $25.12 | $158.49 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $281.84 | Professional | None | $87.10 | $147.91 | $281.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $83.18 Median $380.19 Typical High $2,041.74 | Facility | None | $83.18 | $380.19 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $208.93 | Professional | None | $141.25 | $177.83 | $208.93 |
Priority Health Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $194.98 | Professional | None | $83.18 | $144.54 | $194.98 |
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 $120.23 Median $151.36 Typical High $181.97 | Professional | None | $120.23 | $151.36 | $181.97 |
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 $69.18 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $28.18 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $107.15 Typical High $151.36 | Professional | 54 · Surgery only | $104.71 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.38 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $19.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $70.79 | $97.72 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $39.81 | Professional | 53 · Discontinued | $26.92 | $28.18 | $39.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $107.15 | $147.91 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $29.51 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $19.95 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 32nd of 51
$162
AK $437FL $123
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.