How much rates vary
Facilitymedian $692 · 10th to 90th $126 to $1,445Professionalmedian $224 · 10th to 90th $141 to $257
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 $229.09 Median $234.42 Typical High $4,897.79 | Facility | None | $229.09 | $234.42 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $239.88 | Professional | None | $181.97 | $229.09 | $239.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,202.26 | Facility | None | $691.83 | $707.95 | $1,202.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $38.02 Median $223.87 Typical High $239.88 | Professional | None | $38.02 | $223.87 | $239.88 |
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 $134.90 Median $218.78 Typical High $380.19 | Professional | None | $134.90 | $218.78 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $234.42 Median $575.44 Typical High $4,897.79 | Facility | None | $234.42 | $575.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $257.04 | Professional | None | $194.98 | $239.88 | $257.04 |
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 $134.90 Median $218.78 Typical High $281.84 | Professional | None | $134.90 | $218.78 | $281.84 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $245.47 | Professional | None | $194.98 | $229.09 | $245.47 |
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 $112.20 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $114.82 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $47.86 | $47.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $169.82 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $35.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $23.99 |
Where Michigan sits
The same service costs 20.9 times more in Alabama than in Delaware. 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
AL $7,181DE $344
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.