How much rates vary
Facilitymedian $1,413 · 10th to 90th $126 to $2,399Professionalmedian $457 · 10th to 90th $81 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 $467.74 Median $2,041.74 Typical High $4,897.79 | Facility | None | $467.74 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | None | $467.74 | $478.63 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $2,511.89 | Facility | None | $1,412.54 | $1,445.44 | $2,511.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $81.28 Median $302.00 Typical High $478.63 | Professional | None | $81.28 | $302.00 | $478.63 |
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 $281.84 Median $446.68 Typical High $776.25 | Professional | None | $281.84 | $446.68 | $776.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $4,897.79 | Facility | None | $478.63 | $1,071.52 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $512.86 | Professional | None | $363.08 | $467.74 | $512.86 |
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 $281.84 Median $436.52 Typical High $575.44 | Professional | None | $281.84 | $436.52 | $575.44 |
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 $389.05 Median $457.09 Typical High $489.78 | Professional | None | $389.05 | $457.09 | $489.78 |
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 $234.42 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $47.86 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $234.42 | $239.88 | $239.88 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $346.74 | $363.08 | $363.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $72.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $47.86 |
Where Michigan sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 30th of 51
$457
AK $1,445UT $295
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.