How much rates vary
Facilitymedian $81 · 10th to 90th $60 to $186Professionalmedian $79 · 10th to 90th $62 to $100
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 $60.26 Median $69.18 Typical High $81.28 | Facility | None | $60.26 | $69.18 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $91.20 | Professional | None | $60.26 | $69.18 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $95.50 | Professional | None | $61.66 | $72.44 | $95.50 |
BCBS Michigan Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $97.72 | Facility | None | $77.62 | $97.72 | $97.72 |
BCBS Michigan Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | None | $77.62 | $83.18 | $97.72 |
CareSource Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $120.23 | Professional | None | $74.13 | $102.33 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $158.49 | Professional | None | $54.95 | $77.62 | $158.49 |
Health Alliance Plan Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $204.17 | Facility | None | $60.26 | $81.28 | $204.17 |
Health Alliance Plan Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $109.65 | Professional | None | $61.66 | $77.62 | $109.65 |
Priority Health Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $158.49 | Professional | None | $54.95 | $70.79 | $158.49 |
United Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $100.00 | Professional | None | $64.57 | $77.62 | $100.00 |
15 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 $33.88 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $8.13 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $58.88 Median $72.44 Typical High $72.44 | Professional | 24 · Unrelated visit after surgery | $58.88 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier AM · Physician, team member Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | AM · Physician, team member | $72.44 | $72.44 | $72.44 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $69.18 Median $70.79 Typical High $72.44 | Professional | FS · Shared visit | $69.18 | $70.79 | $72.44 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $69.18 Median $95.50 Typical High $104.71 | Professional | GC · Resident with teaching physician | $69.18 | $95.50 | $104.71 |
Health Alliance Plan Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $61.66 Median $83.18 Typical High $117.49 | Professional | 24 · Unrelated visit after surgery | $61.66 | $83.18 | $117.49 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $61.66 Median $114.82 Typical High $199.53 | Professional | 25 · Same-day visit | $61.66 | $114.82 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Health Alliance Plan Setting Professional Modifier 57 · Decision for surgery Typical Low $61.66 Median $85.11 Typical High $112.20 | Professional | 57 · Decision for surgery | $61.66 | $85.11 | $112.20 |
Health Alliance Plan Setting Professional Modifier FS · Shared visit Typical Low $67.61 Median $77.62 Typical High $125.89 | Professional | FS · Shared visit | $67.61 | $77.62 | $125.89 |
Health Alliance Plan Setting Professional Modifier GC · Resident with teaching physician Typical Low $56.23 Median $77.62 Typical High $177.83 | Professional | GC · Resident with teaching physician | $56.23 | $77.62 | $177.83 |
Where Michigan sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 24th of 51
$79.43
AK $155AL $64.57
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.