How much rates vary
Facilitymedian $661 · 10th to 90th $107 to $2,138Professionalmedian $692 · 10th to 90th $575 to $2,455
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 $660.69 Median $676.08 Typical High $6,918.31 | Facility | None | $660.69 | $676.08 | $6,918.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $549.54 Median $676.08 Typical High $691.83 | Professional | None (both parts) | $549.54 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | 26 · Professional part | $416.87 | $524.81 | $524.81 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $158.49 Typical High $165.96 | Professional | TC · Technical part | $131.83 | $158.49 | $165.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $2,089.30 | Facility | None | $478.63 | $1,071.52 | $2,089.30 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $158.49 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $158.49 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None (both parts) Typical Low $398.11 Median $741.31 Typical High $933.25 | Professional | None (both parts) | $398.11 | $741.31 | $933.25 |
Health Alliance Plan Setting Facility Modifier None Typical Low $691.83 Median $1,698.24 Typical High $4,897.79 | Facility | None | $691.83 | $1,698.24 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $575.44 Median $691.83 Typical High $2,454.71 | Professional | None (both parts) | $575.44 | $691.83 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $446.68 Median $524.81 Typical High $645.65 | Professional | 26 · Professional part | $446.68 | $524.81 | $645.65 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $138.04 Median $162.18 Typical High $1,949.84 | Professional | TC · Technical part | $138.04 | $162.18 | $1,949.84 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $398.11 Median $724.44 Typical High $891.25 | Professional | None (both parts) | $398.11 | $724.44 | $891.25 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,445.44 | Facility | None | $89.13 | $177.83 | $1,445.44 |
United Setting Professional Modifier None (both parts) Typical Low $776.25 Median $1,862.09 Typical High $3,162.28 | Professional | None (both parts) | $776.25 | $1,862.09 | $3,162.28 |
United Setting Professional Modifier 26 · Professional part Typical Low $457.09 Median $512.86 Typical High $676.08 | Professional | 26 · Professional part | $457.09 | $512.86 | $676.08 |
United Setting Professional Modifier TC · Technical part Typical Low $316.23 Median $1,513.56 Typical High $2,570.40 | Professional | TC · Technical part | $316.23 | $1,513.56 | $2,570.40 |
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 $281.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $69.18 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $138.04 | $138.04 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $512.86 | $512.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $102.33 | $102.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $69.18 |
Where Michigan sits
The same service costs 5.6 times more in Nebraska than in Maryland. 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· 41st of 51
$692
NE $2,818MD $501
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.