How much rates vary
Facilitymedian $347 · 10th to 90th $120 to $1,259Professionalmedian $155 · 10th to 90th $132 to $214
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 $134.90 Median $177.83 Typical High $4,897.79 | Facility | None | $134.90 | $177.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $177.83 | Professional | None | $134.90 | $141.25 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $239.88 Median $602.56 Typical High $1,202.26 | Facility | None | $239.88 | $602.56 | $1,202.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $269.15 | Professional | None | $190.55 | $199.53 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $223.87 | Professional | None | $93.33 | $151.36 | $223.87 |
Health Alliance Plan Setting Facility Modifier None Typical Low $154.88 Median $354.81 Typical High $4,897.79 | Facility | None | $154.88 | $354.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $186.21 | Professional | None | $131.83 | $154.88 | $186.21 |
Priority Health Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $204.17 | Professional | None | $64.57 | $141.25 | $204.17 |
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 $109.65 Median $141.25 Typical High $162.18 | Professional | None | $109.65 | $141.25 | $162.18 |
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 $67.61 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $67.61 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $26.92 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $14.45 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $77.62 | $77.62 | $77.62 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $30.90 | $30.90 | $30.90 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $117.49 | $117.49 | $117.49 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $15.49 |
Where Michigan sits
The same service costs 3.2 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
$155
AK $347KY $107
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.