How much rates vary
Facilitymedian $126 · 10th to 90th $91 to $407Professionalmedian $98 · 10th to 90th $60 to $166
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 $61.66 Median $91.20 Typical High $4,897.79 | Facility | None | $61.66 | $91.20 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $104.71 | Professional | None | $61.66 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $30.90 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $12.30 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $53.70 Typical High $75.86 | Professional | 54 · Surgery only | $46.77 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $9.33 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
BCBS Michigan Setting Facility Modifier None Typical Low $107.15 Median $109.65 Typical High $190.55 | Facility | None | $107.15 | $109.65 | $190.55 |
BCBS Michigan Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $102.33 | Professional | None | $63.10 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $181.97 | Professional | None | $50.12 | $77.62 | $181.97 |
Health Alliance Plan Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $407.38 | Facility | None | $67.61 | $158.49 | $407.38 |
Health Alliance Plan Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $181.97 | Professional | None | $60.26 | $97.72 | $181.97 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $33.88 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $33.88 | $48.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.49 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $13.49 | $19.50 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $50.12 Typical High $74.13 | Professional | 54 · Surgery only | $45.71 | $50.12 | $74.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $14.79 | Professional | 55 · Aftercare only | $9.12 | $10.00 | $14.79 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $6.76 | $9.77 |
Priority Health Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $151.36 | Professional | None | $47.86 | $72.44 | $151.36 |
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 $165.96 | Professional | None | $63.10 | $95.50 | $165.96 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 50 · Both sides | $70.79 | $70.79 | $70.79 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $194.98 Typical High $194.98 | Professional | 50 · Both sides | $93.33 | $194.98 | $194.98 |
Where Michigan sits
The same service costs 3.2 times more in Wisconsin 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· 24th of 51
$100
WI $229KY $72.44
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.