How much rates vary
Facilitymedian $1,259 · 10th to 90th $324 to $2,754Professionalmedian $151 · 10th to 90th $112 to $200
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 $134.90 Median $190.55 Typical High $4,897.79 | Facility | None | $134.90 | $190.55 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $190.55 | Professional | None | $134.90 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $67.61 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $100.00 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $20.42 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $19.05 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,288.25 | $2,187.76 |
BCBS Michigan Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $199.53 | Professional | None | $83.18 | $144.54 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $83.18 Median $131.83 Typical High $331.13 | Professional | None | $83.18 | $131.83 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $181.97 Median $933.25 Typical High $4,897.79 | Facility | None | $181.97 | $933.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $199.53 | Professional | None | $134.90 | $173.78 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $67.61 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $67.61 | $95.50 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $27.54 Typical High $38.02 | Professional | 53 · Discontinued | $26.30 | $27.54 | $38.02 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $97.72 | $102.33 | $141.25 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $28.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $19.05 |
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 $79.43 Median $109.65 Typical High $302.00 | Professional | None | $79.43 | $109.65 | $302.00 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $3,019.95 | Facility | None | $288.40 | $426.58 | $3,019.95 |
United Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $186.21 | Professional | None | $107.15 | $147.91 | $186.21 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 50 · Both sides | $213.80 | $213.80 | $213.80 |
Where Michigan sits
The same service costs 10.9 times more in Colorado than in Montana. 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
CO $3,950MT $363
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.