How much rates vary
Facilitymedian $380 · 10th to 90th $117 to $871Professionalmedian $132 · 10th to 90th $102 to $191
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 $120.23 Median $158.49 Typical High $4,897.79 | Facility | None | $120.23 | $158.49 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $158.49 | Professional | None | $117.49 | $131.83 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $114.82 | Professional | None | $77.62 | $109.65 | $114.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $660.69 | Facility | None | $380.19 | $389.05 | $660.69 |
BCBS Michigan Setting Professional Modifier None Typical Low $23.44 Median $125.89 Typical High $190.55 | Professional | None | $23.44 | $125.89 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $331.13 | Professional | None | $67.61 | $117.49 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $83.18 Median $323.59 Typical High $2,041.74 | Facility | None | $83.18 | $323.59 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | None | $117.49 | $134.90 | $158.49 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $218.78 | Professional | None | $66.07 | $102.33 | $218.78 |
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 $114.82 Median $162.18 Typical High $229.09 | Professional | None | $114.82 | $162.18 | $229.09 |
12 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 $60.26 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $15.14 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 50 · Both sides | $109.65 | $109.65 | $109.65 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 50 · Both sides | $186.21 | $281.84 | $281.84 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $58.88 | $61.66 | $75.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $24.55 | $30.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $89.13 | $93.33 | $114.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $17.78 | $18.62 | $22.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $12.30 | $15.14 |
Where Michigan sits
The same service costs 3.7 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· 35th of 51
$135
AK $363FL $97.72
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.