How much rates vary
Facilitymedian $251 · 10th to 90th $126 to $692Professionalmedian $138 · 10th to 90th $89 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 $131.83 Median $151.36 Typical High $4,897.79 | Facility | None | $131.83 | $151.36 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $154.88 | Professional | None | $109.65 | $138.04 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $257.04 Typical High $436.52 | Facility | None | $251.19 | $257.04 | $436.52 |
BCBS Michigan Setting Professional Modifier None Typical Low $22.39 Median $141.25 Typical High $199.53 | Professional | None | $22.39 | $141.25 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $323.59 | Professional | None | $79.43 | $117.49 | $323.59 |
Health Alliance Plan Setting Facility Modifier None Typical Low $134.90 Median $309.03 Typical High $4,897.79 | Facility | None | $134.90 | $309.03 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $158.49 | Professional | None | $114.82 | $134.90 | $158.49 |
Priority Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $208.93 | Professional | None | $75.86 | $95.50 | $208.93 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,258.93 | Facility | None | $91.20 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $151.36 | Professional | None | $107.15 | $123.03 | $151.36 |
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 $66.07 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $66.07 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $26.30 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $100.00 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $19.95 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.18 | $13.80 | $15.49 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 50 · Both sides | $213.80 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $67.61 Typical High $77.62 | Professional | 52 · Reduced service | $64.57 | $67.61 | $77.62 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $30.90 | Professional | 53 · Discontinued | $26.30 | $26.92 | $30.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $97.72 | $102.33 | $114.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $22.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $15.49 |
Where Michigan sits
The same service costs 4.5 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· 29th of 51
$138
AK $407FL $91.20
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.