How much rates vary
Facilitymedian $437 · 10th to 90th $129 to $1,122Professionalmedian $174 · 10th to 90th $98 to $295
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 $281.84 Typical High $2,041.74 | Facility | None | $125.89 | $281.84 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $295.12 | Professional | None | $123.03 | $165.96 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $239.88 | Professional | None | $112.20 | $114.82 | $239.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $758.58 | Facility | None | $436.52 | $436.52 | $758.58 |
BCBS Michigan Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $331.13 | Professional | None | $70.79 | $112.20 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $316.23 | Professional | None | $87.10 | $169.82 | $316.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $107.15 Median $288.40 Typical High $2,041.74 | Facility | None | $107.15 | $288.40 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $295.12 | Professional | None | $120.23 | $213.80 | $295.12 |
Priority Health Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $309.03 | Professional | None | $97.72 | $169.82 | $309.03 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $251.19 | Professional | None | $104.71 | $169.82 | $251.19 |
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 $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $63.10 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $25.12 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $93.33 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $18.62 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $12.59 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $87.10 | $147.91 | $194.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $79.43 Typical High $144.54 | Professional | 52 · Reduced service | $60.26 | $79.43 | $144.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $31.62 Typical High $57.54 | Professional | 53 · Discontinued | $23.99 | $31.62 | $57.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $109.65 Typical High $213.80 | Professional | 54 · Surgery only | $91.20 | $109.65 | $213.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $23.44 Typical High $42.66 | Professional | 55 · Aftercare only | $18.20 | $23.44 | $42.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.85 Typical High $28.84 | Professional | 56 · Pre-op care only | $12.02 | $15.85 | $28.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $109.65 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $85.11 | $109.65 | $199.53 |
Where Michigan sits
The same service costs 4.1 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· 43rd of 51
$182
AK $501KY $123
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.