How much rates vary
Facilitymedian $5,495 · 10th to 90th $912 to $8,913Professionalmedian $851 · 10th to 90th $191 to $912
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 $4,897.79 Typical High $6,918.31 | Facility | None | $891.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | None | $630.96 | $912.01 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
BCBS Michigan Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $9,549.93 | Facility | None | $5,495.41 | $5,495.41 | $9,549.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $151.36 Median $562.34 Typical High $891.25 | Professional | None | $151.36 | $562.34 | $891.25 |
CareSource Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,995.26 | Professional | None | $489.78 | $776.25 | $1,995.26 |
Health Alliance Plan Setting Facility Modifier None Typical Low $912.01 Median $3,235.94 Typical High $5,754.40 | Facility | None | $912.01 | $3,235.94 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $912.01 | Professional | None | $676.08 | $831.76 | $912.01 |
Priority Health Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,995.26 | Professional | None | $489.78 | $724.44 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $7,943.28 | Facility | None | $851.14 | $2,290.87 | $7,943.28 |
United Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,096.48 | Professional | None | $776.25 | $870.96 | $1,096.48 |
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 $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 $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $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 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | 50 · Both sides | $954.99 | $954.99 | $954.99 |
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 $173.78 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $173.78 | $181.97 | $181.97 |
Health Alliance Plan 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 |
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 5.9 times more in Alaska 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
AK $12,304MT $2,095
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.