How much rates vary
Facilitymedian $269 · 10th to 90th $126 to $617Professionalmedian $126 · 10th to 90th $93 to $158
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 $125.89 Median $147.91 Typical High $2,041.74 | Facility | None | $125.89 | $147.91 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | None | $112.20 | $134.90 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $128.82 | Professional | None | $95.50 | $123.03 | $128.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $467.74 | Facility | None | $269.15 | $275.42 | $467.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $21.88 Median $114.82 Typical High $158.49 | Professional | None | $21.88 | $114.82 | $158.49 |
CareSource Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $190.55 | Professional | None | $83.18 | $114.82 | $190.55 |
Health Alliance Plan Setting Facility Modifier None Typical Low $125.89 Median $302.00 Typical High $707.95 | Facility | None | $125.89 | $302.00 | $707.95 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $181.97 | Professional | None | $112.20 | $138.04 | $181.97 |
Priority Health Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $190.55 | Professional | None | $85.11 | $114.82 | $190.55 |
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 $100.00 Median $120.23 Typical High $147.91 | Professional | None | $100.00 | $120.23 | $147.91 |
12 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 $63.10 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $93.33 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $89.13 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $87.10 | $89.13 | $104.71 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $60.26 | $60.26 | $72.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $24.55 | $28.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $102.33 Typical High $107.15 | Professional | 54 · Surgery only | $91.20 | $102.33 | $107.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $21.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.45 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $102.33 |
Where Michigan sits
The same service costs 4.4 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· 30th of 51
$129
AK $437KY $100
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.