How much rates vary
Facilitymedian $324 · 10th to 90th $120 to $708Professionalmedian $107 · 10th to 90th $71 to $170
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 $83.18 Median $85.11 Typical High $6,918.31 | Facility | None | $83.18 | $85.11 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | None | $83.18 | $87.10 | $91.20 |
BCBS Michigan Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $575.44 | Facility | None | $323.59 | $331.13 | $575.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $169.82 | Professional | None | $66.07 | $120.23 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Health Alliance Plan Setting Facility Modifier None Typical Low $87.10 Median $269.15 Typical High $4,897.79 | Facility | None | $87.10 | $269.15 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $123.03 | Professional | None | $87.10 | $100.00 | $123.03 |
Priority Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
United Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $1,258.93 | Facility | None | $89.13 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | None | $93.33 | $112.20 | $123.03 |
11 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 $41.69 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 54 · Surgery only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $8.71 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 50 · Both sides | $181.97 | $181.97 | $181.97 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $17.38 | $17.38 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 54 · Surgery only | $64.57 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Where Michigan sits
The same service costs 16.6 times more in Alabama than in Delaware. 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.
Physician feeFacility fee
AL $3,321DE $200
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.