How much rates vary
Facilitymedian $115 · 10th to 90th $59 to $282Professionalmedian $85 · 10th to 90th $40 to $120
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 $109.65 Median $109.65 Typical High $169.82 | Facility | None | $109.65 | $109.65 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $229.09 | Professional | None | $67.61 | $109.65 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $91.20 | Professional | None | $57.54 | $91.20 | $91.20 |
BCBS Michigan Setting Facility Modifier None Typical Low $85.11 Median $120.23 Typical High $213.80 | Facility | None | $85.11 | $120.23 | $213.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $114.82 Typical High $147.91 | Professional | None | $38.02 | $114.82 | $147.91 |
Health Alliance Plan Setting Facility Modifier None Typical Low $54.95 Median $114.82 Typical High $281.84 | Facility | None | $54.95 | $114.82 | $281.84 |
Health Alliance Plan Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $138.04 | Professional | None | $48.98 | $75.86 | $138.04 |
Priority Health Setting Professional Modifier None Typical Low $38.02 Median $114.82 Typical High $134.90 | Professional | None | $38.02 | $114.82 | $134.90 |
United Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $138.04 | Facility | None | $69.18 | $102.33 | $138.04 |
United Setting Professional Modifier None Typical Low $21.88 Median $44.67 Typical High $79.43 | Professional | None | $21.88 | $44.67 | $79.43 |
20 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 Facility Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $85.11 | Facility | 52 · Reduced service | $54.95 | $54.95 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $33.88 | Facility | 53 · Discontinued | $21.88 | $21.88 | $33.88 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $125.89 | Facility | 54 · Surgery only | $81.28 | $81.28 | $125.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $25.70 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $16.98 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $54.95 Typical High $57.54 | Professional | 52 · Reduced service | $48.98 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.88 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $83.18 Typical High $87.10 | Professional | 54 · Surgery only | $74.13 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.60 Typical High $17.38 | Professional | 55 · Aftercare only | $14.79 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $11.48 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $11.48 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $85.11 | Facility | 52 · Reduced service | $54.95 | $54.95 | $85.11 |
Health Alliance Plan Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $33.88 | Facility | 53 · Discontinued | $21.88 | $21.88 | $33.88 |
Health Alliance Plan Setting Facility Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $125.89 | Facility | 54 · Surgery only | $81.28 | $81.28 | $125.89 |
Health Alliance Plan Setting Facility Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $25.70 | Facility | 55 · Aftercare only | $16.22 | $16.22 | $25.70 |
Health Alliance Plan Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $16.98 | Facility | 56 · Pre-op care only | $10.96 | $10.96 | $16.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.88 | $21.88 | $21.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $81.28 | $81.28 | $81.28 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.22 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $10.96 |
Where Michigan sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 26th of 51
$93.33
AK $224GA $45.71
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.