How much rates vary
Facilitymedian $4,786 · 10th to 90th $891 to $12,023Professionalmedian $437 · 10th to 90th $339 to $501
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 $380.19 Median $4,897.79 Typical High $6,918.31 | Facility | None | $380.19 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $10,715.19 | Professional | None (both parts) | $380.19 | $380.19 | $10,715.19 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $363.08 Typical High $380.19 | Professional | 26 · Professional part | $316.23 | $363.08 | $380.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,715.35 Median $9,332.54 Typical High $18,620.87 | Facility | None | $3,715.35 | $9,332.54 | $18,620.87 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $416.87 | $446.68 | $446.68 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $436.52 Typical High $489.78 | Professional | 26 · Professional part | $204.17 | $436.52 | $489.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $4,786.30 Median $4,897.79 Typical High $6,918.31 | Facility | None | $4,786.30 | $4,897.79 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None (both parts) | $309.03 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $371.54 Typical High $416.87 | Professional | 26 · Professional part | $295.12 | $371.54 | $416.87 |
Priority Health Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $407.38 Typical High $478.63 | Professional | 26 · Professional part | $204.17 | $407.38 | $478.63 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,762.47 | Facility | None | $851.14 | $2,238.72 | $7,762.47 |
United Setting Professional Modifier None (both parts) Typical Low $323.59 Median $389.05 Typical High $501.19 | Professional | None (both parts) | $323.59 | $389.05 | $501.19 |
United Setting Professional Modifier 26 · Professional part Typical Low $323.59 Median $389.05 Typical High $501.19 | Professional | 26 · Professional part | $323.59 | $389.05 | $501.19 |
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 $177.83 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $70.79 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $38.02 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $77.62 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $288.40 | $288.40 | $288.40 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $57.54 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where Michigan sits
The same service costs 23.4 times more in Colorado 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· 46th of 51
$447
CO $6,761KY $288
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.