How much rates vary
Facilitymedian $427 · 10th to 90th $151 to $1,380Professionalmedian $219 · 10th to 90th $135 to $269
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 $218.78 Median $251.19 Typical High $2,884.03 | Facility | None | $218.78 | $251.19 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $275.42 | Professional | None | $186.21 | $239.88 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $269.15 | Professional | None | $134.90 | $269.15 | $269.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $1,318.26 | Facility | None | $426.58 | $549.54 | $1,318.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $33.88 Median $199.53 Typical High $269.15 | Professional | None | $33.88 | $199.53 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $316.23 | Professional | None | $141.25 | $194.98 | $316.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $162.18 Median $316.23 Typical High $2,089.30 | Facility | None | $162.18 | $316.23 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $281.84 | Professional | None | $199.53 | $229.09 | $281.84 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $316.23 | Professional | None | $141.25 | $194.98 | $316.23 |
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 $181.97 Median $213.80 Typical High $263.03 | Professional | None | $181.97 | $213.80 | $263.03 |
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 $109.65 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $177.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $107.15 | $107.15 | $123.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $42.66 | $42.66 | $48.98 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $158.49 | $158.49 | $186.21 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $37.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $24.55 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $173.78 |
Where Michigan sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 28th of 51
$224
AK $759FL $174
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.