How much rates vary
Facilitymedian $186 · 10th to 90th $89 to $589Professionalmedian $76 · 10th to 90th $45 to $105
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 $66.07 Median $87.10 Typical High $4,897.79 | Facility | None | $66.07 | $87.10 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $95.50 | Professional | None | $66.07 | $72.44 | $95.50 |
BCBS Michigan Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $562.34 | Facility | None | $177.83 | $229.09 | $562.34 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.96 Median $69.18 Typical High $109.65 | Professional | None | $10.96 | $69.18 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $147.91 | Professional | None | $40.74 | $64.57 | $147.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $69.18 Median $158.49 Typical High $416.87 | Facility | None | $69.18 | $158.49 | $416.87 |
Health Alliance Plan Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $104.71 | Professional | None | $66.07 | $87.10 | $104.71 |
Priority Health Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $123.03 | Professional | None | $38.90 | $53.70 | $123.03 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | None | $61.66 | $75.86 | $89.13 |
11 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 $32.36 Median $33.88 Typical High $44.67 | Professional | 52 · Reduced service | $32.36 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $13.18 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $50.12 Typical High $67.61 | Professional | 54 · Surgery only | $48.98 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $13.49 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $9.12 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | 50 · Both sides | $102.33 | $102.33 | $165.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.88 Typical High $44.67 | Professional | 52 · Reduced service | $32.36 | $33.88 | $44.67 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $12.88 | $13.49 | $18.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $50.12 Typical High $67.61 | Professional | 54 · Surgery only | $48.98 | $50.12 | $67.61 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $13.49 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $13.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $9.12 |
Where Michigan sits
The same service costs 3.6 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· 26th of 51
$79.43
AK $200FL $54.95
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.