How much rates vary
Facilitymedian $2,455 · 10th to 90th $126 to $4,074Professionalmedian $891 · 10th to 90th $537 to $1,000
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 $891.25 Median $2,884.03 Typical High $4,897.79 | Facility | None | $891.25 | $2,884.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $4,265.80 | Facility | None | $2,454.71 | $2,454.71 | $4,265.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $173.78 Median $912.01 Typical High $912.01 | Professional | None | $173.78 | $912.01 | $912.01 |
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 $524.81 Median $831.76 Typical High $1,174.90 | Professional | None | $524.81 | $831.76 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $4,897.79 | Facility | None | $912.01 | $2,238.72 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,071.52 | Professional | None | $758.58 | $912.01 | $1,071.52 |
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 $524.81 Median $831.76 Typical High $1,071.52 | Professional | None | $524.81 | $831.76 | $1,071.52 |
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 $724.44 Median $831.76 Typical High $912.01 | Professional | None | $724.44 | $831.76 | $912.01 |
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 $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $436.52 | $457.09 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $91.20 |
Where Michigan sits
The same service costs 4.7 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· 27th of 51
$891
AK $2,754UT $589
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.