How much rates vary
Facilitymedian $525 · 10th to 90th $126 to $1,148Professionalmedian $234 · 10th to 90th $174 to $479
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 $234.42 Median $2,884.03 Typical High $4,897.79 | Facility | None | $234.42 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | None | $234.42 | $239.88 | $239.88 |
BCBS Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $933.25 | Facility | None | $524.81 | $537.03 | $933.25 |
BCBS Setting Professional Modifier None Typical Low $151.36 Median $457.09 Typical High $478.63 | Professional | None | $151.36 | $457.09 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $323.59 | Professional | None | $138.04 | $208.93 | $323.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $239.88 Median $562.34 Typical High $4,897.79 | Facility | None | $239.88 | $562.34 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $263.03 | Professional | None | $190.55 | $234.42 | $263.03 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $281.84 | Professional | None | $138.04 | $186.21 | $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 $169.82 Median $218.78 Typical High $234.42 | Professional | None | $169.82 | $218.78 | $234.42 |
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 $117.49 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $46.77 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $173.78 | $177.83 | $177.83 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $23.99 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $114.82 | $120.23 | $120.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $46.77 | $47.86 | $47.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $173.78 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $36.31 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.44 | $23.99 | $23.99 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in New York. 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· 27th of 51
$234
AK $724NY $162
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.