How much rates vary
Facilitymedian $295 · 10th to 90th $115 to $832Professionalmedian $138 · 10th to 90th $105 to $166
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 $114.82 Median $151.36 Typical High $2,884.03 | Facility | None | $114.82 | $151.36 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $158.49 | Professional | None | $112.20 | $128.82 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $131.83 | Professional | None | $89.13 | $131.83 | $131.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $295.12 Median $302.00 Typical High $524.81 | Facility | None | $295.12 | $302.00 | $524.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $162.18 | Professional | None | $95.50 | $147.91 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $181.97 | Professional | None | $75.86 | $114.82 | $181.97 |
Health Alliance Plan Setting Facility Modifier None Typical Low $112.20 Median $354.81 Typical High $1,288.25 | Facility | None | $112.20 | $354.81 | $1,288.25 |
Health Alliance Plan Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $169.82 | Professional | None | $112.20 | $147.91 | $169.82 |
Priority Health Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $181.97 | Professional | None | $87.10 | $120.23 | $181.97 |
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 $104.71 Median $128.82 Typical High $162.18 | Professional | None | $104.71 | $128.82 | $162.18 |
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 $57.54 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $81.28 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $79.43 | $81.28 | $107.15 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $56.23 | $75.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $22.39 | $30.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 54 · Surgery only | $85.11 | $85.11 | $112.20 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $22.39 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $15.14 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $104.71 |
Where Michigan sits
The same service costs 3.8 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· 22nd of 51
$148
AK $389KY $102
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.