How much rates vary
Facilitymedian $126 · 10th to 90th $79 to $339Professionalmedian $91 · 10th to 90th $56 to $148
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 $57.54 Median $93.33 Typical High $128.82 | Facility | None | $57.54 | $93.33 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $112.20 | Professional | None | $57.54 | $79.43 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $46.77 | Professional | None | $34.67 | $43.65 | $46.77 |
BCBS Michigan Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $208.93 | Facility | None | $120.23 | $120.23 | $208.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $134.90 | Professional | None | $64.57 | $69.18 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $162.18 | Professional | None | $46.77 | $77.62 | $162.18 |
Health Alliance Plan Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $338.84 | Facility | None | $64.57 | $128.82 | $338.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $165.96 | Professional | None | $58.88 | $102.33 | $165.96 |
Priority Health Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $134.90 | Professional | None | $43.65 | $69.18 | $134.90 |
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 $58.88 Median $91.20 Typical High $151.36 | Professional | None | $58.88 | $91.20 | $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 $28.84 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.45 Typical High $20.42 | Professional | 53 · Discontinued | $11.48 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $54.95 Typical High $75.86 | Professional | 54 · Surgery only | $42.66 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $15.14 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $10.23 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $102.33 Typical High $204.17 | Professional | 50 · Both sides | $102.33 | $102.33 | $204.17 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $28.18 | $35.48 | $50.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $13.49 Typical High $19.95 | Professional | 53 · Discontinued | $11.22 | $13.49 | $19.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $50.12 Typical High $75.86 | Professional | 54 · Surgery only | $41.69 | $50.12 | $75.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $15.14 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.62 | $6.76 | $10.00 |
Where Michigan sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 27th of 51
$93.33
AK $214KY $64.57
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.