How much rates vary
Facilitymedian $1,820 · 10th to 90th $794 to $4,898Professionalmedian $832 · 10th to 90th $447 to $1,096
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 $758.58 Median $2,041.74 Typical High $4,897.79 | Facility | None | $758.58 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None (both parts) Typical Low $691.83 Median $794.33 Typical High $831.76 | Professional | None (both parts) | $691.83 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $302.00 Typical High $316.23 | Professional | 26 · Professional part | $239.88 | $302.00 | $316.23 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $446.68 Median $489.78 Typical High $512.86 | Professional | TC · Technical part | $446.68 | $489.78 | $512.86 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 26 · Professional part | $229.09 | $229.09 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $912.01 Median $1,995.26 Typical High $3,981.07 | Facility | None | $912.01 | $1,995.26 | $3,981.07 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $181.97 Median $660.69 Typical High $1,000.00 | Professional | None (both parts) | $181.97 | $660.69 | $1,000.00 |
Cigna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $1,023.29 Typical High $1,348.96 | Professional | None (both parts) | $467.74 | $1,023.29 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $4,897.79 | Facility | None | $1,000.00 | $2,344.23 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $724.44 Median $831.76 Typical High $1,122.02 | Professional | None (both parts) | $724.44 | $831.76 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $295.12 Typical High $389.05 | Professional | 26 · Professional part | $251.19 | $295.12 | $389.05 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $549.54 Typical High $776.25 | Professional | TC · Technical part | $467.74 | $549.54 | $776.25 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $467.74 Median $912.01 Typical High $1,258.93 | Professional | None (both parts) | $467.74 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,548.82 Typical High $6,456.54 | Facility | None | $660.69 | $1,548.82 | $6,456.54 |
United Setting Professional Modifier None (both parts) Typical Low $724.44 Median $891.25 Typical High $1,096.48 | Professional | None (both parts) | $724.44 | $891.25 | $1,096.48 |
United Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $295.12 Typical High $371.54 | Professional | 26 · Professional part | $257.04 | $295.12 | $371.54 |
United Setting Professional Modifier TC · Technical part Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | TC · Technical part | $489.78 | $588.84 | $741.31 |
10 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 $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $389.05 | $416.87 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $165.96 | $165.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $588.84 | $616.60 | $616.60 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Where Michigan sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 39th of 51
$832
WI $2,630TX $603
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.