How much rates vary
Facilitymedian $126 · 10th to 90th $89 to $468Professionalmedian $30 · 10th to 90th $22 to $66
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 $24.55 Median $29.51 Typical High $4,897.79 | Facility | None | $24.55 | $29.51 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $28.84 Typical High $38.02 | Professional | None | $24.55 | $28.84 | $38.02 |
BCBS Michigan Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Facility | None | $114.82 | $114.82 | $199.53 |
BCBS Michigan Setting Professional Modifier None Typical Low $13.49 Median $22.91 Typical High $33.11 | Professional | None | $13.49 | $22.91 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $81.28 | Professional | None | $15.14 | $41.69 | $81.28 |
Health Alliance Plan Setting Facility Modifier None Typical Low $28.84 Median $138.04 Typical High $4,897.79 | Facility | None | $28.84 | $138.04 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $25.12 Median $41.69 Typical High $67.61 | Professional | None | $25.12 | $41.69 | $67.61 |
Priority Health Setting Professional Modifier None Typical Low $15.14 Median $34.67 Typical High $58.88 | Professional | None | $15.14 | $34.67 | $58.88 |
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 $28.18 Median $57.54 Typical High $70.79 | Professional | None | $28.18 | $57.54 | $70.79 |
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 $12.30 Median $12.88 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $5.89 | Professional | 53 · Discontinued | $5.01 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $19.05 Typical High $22.39 | Professional | 54 · Surgery only | $18.62 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $4.47 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.95 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 50 · Both sides | $34.67 | $34.67 | $34.67 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $13.18 Typical High $14.79 | Professional | 52 · Reduced service | $12.59 | $13.18 | $14.79 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.25 Typical High $5.89 | Professional | 53 · Discontinued | $5.01 | $5.25 | $5.89 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $19.50 Typical High $22.39 | Professional | 54 · Surgery only | $19.05 | $19.50 | $22.39 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.89 Typical High $4.47 | Professional | 55 · Aftercare only | $3.80 | $3.89 | $4.47 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.63 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.51 | $2.63 | $2.95 |
Where Michigan sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 43rd of 51
$30.90
WY $89.13NY $20.89
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.