How much rates vary
Facilitymedian $302 · 10th to 90th $69 to $724Professionalmedian $78 · 10th to 90th $56 to $129
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 $63.10 Median $70.79 Typical High $4,897.79 | Facility | None | $63.10 | $70.79 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $75.86 | Professional | None | $61.66 | $66.07 | $75.86 |
BCBS Michigan Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $537.03 | Facility | None | $302.00 | $309.03 | $537.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $37.15 Median $85.11 Typical High $89.13 | Professional | None | $37.15 | $85.11 | $89.13 |
CareSource Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
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 $37.15 Median $72.44 Typical High $134.90 | Professional | None | $37.15 | $72.44 | $134.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $2,041.74 | Facility | None | $58.88 | $79.43 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $134.90 | Professional | None | $63.10 | $93.33 | $134.90 |
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 $36.31 Median $66.07 Typical High $100.00 | Professional | None | $36.31 | $66.07 | $100.00 |
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 $63.10 Median $95.50 Typical High $125.89 | Professional | None | $63.10 | $95.50 | $125.89 |
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 $30.90 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $47.86 Typical High $51.29 | Professional | 54 · Surgery only | $45.71 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.31 | $6.92 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | 50 · Both sides | $95.50 | $95.50 | $128.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $31.62 | $34.67 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.88 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $12.88 | $13.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $47.86 Typical High $52.48 | Professional | 54 · Surgery only | $45.71 | $47.86 | $52.48 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $10.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.17 | $6.31 | $6.92 |
Where Michigan sits
The same service costs 3.6 times more in Wyoming 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· 25th of 51
$85.11
WY $191FL $52.48
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.