How much rates vary
Facilitymedian $105 · 10th to 90th $76 to $302Professionalmedian $72 · 10th to 90th $35 to $191
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 $89.13 Median $93.33 Typical High $95.50 | Facility | None | $89.13 | $93.33 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $93.33 Typical High $93.33 | Professional | None | $38.02 | $93.33 | $93.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $213.80 | Facility | None | $75.86 | $97.72 | $213.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | None | $181.97 | $190.55 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $60.26 | Facility | None | $36.31 | $36.31 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $60.26 Typical High $95.50 | Professional | None | $27.54 | $60.26 | $95.50 |
Health Alliance Plan Setting Facility Modifier None Typical Low $95.50 Median $218.78 Typical High $371.54 | Facility | None | $95.50 | $218.78 | $371.54 |
Health Alliance Plan Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $100.00 | Professional | None | $36.31 | $46.77 | $100.00 |
Priority Health Setting Professional Modifier None Typical Low $28.84 Median $57.54 Typical High $85.11 | Professional | None | $28.84 | $57.54 | $85.11 |
United Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $562.34 | Facility | None | $204.17 | $269.15 | $562.34 |
United Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $77.62 | Professional | None | $32.36 | $37.15 | $77.62 |
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 $44.67 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $19.05 | Professional | 53 · Discontinued | $17.78 | $18.62 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $69.18 Typical High $70.79 | Professional | 54 · Surgery only | $66.07 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $9.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.95 | $19.95 | $19.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 54 · Surgery only | $75.86 | $75.86 | $75.86 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 19th of 51
$85.11
AK $141OH $31.62
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.