How much rates vary
Facilitymedian $741 · 10th to 90th $158 to $2,042Professionalmedian $151 · 10th to 90th $87 to $214
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 $138.04 Median $199.53 Typical High $2,884.03 | Facility | None | $138.04 | $199.53 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $208.93 | Professional | None | $134.90 | $169.82 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | None | $102.33 | $120.23 | $120.23 |
BCBS Michigan Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $1,288.25 | Facility | None | $741.31 | $758.58 | $1,288.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $23.44 Median $123.03 Typical High $208.93 | Professional | None | $23.44 | $123.03 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $93.33 Median $131.83 Typical High $177.83 | Professional | None | $93.33 | $131.83 | $177.83 |
Health Alliance Plan Setting Facility Modifier None Typical Low $141.25 Median $446.68 Typical High $4,897.79 | Facility | None | $141.25 | $446.68 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $218.78 | Professional | None | $134.90 | $190.55 | $218.78 |
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 $95.50 Median $131.83 Typical High $177.83 | Professional | None | $95.50 | $131.83 | $177.83 |
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 $117.49 Median $162.18 Typical High $208.93 | Professional | None | $117.49 | $162.18 | $208.93 |
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 $69.18 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $69.18 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $29.51 Typical High $39.81 | Professional | 53 · Discontinued | $27.54 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $109.65 Typical High $147.91 | Professional | 54 · Surgery only | $102.33 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.88 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.80 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $102.33 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $95.50 | $102.33 | $138.04 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $70.79 Typical High $97.72 | Professional | 52 · Reduced service | $67.61 | $70.79 | $97.72 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $26.92 | $28.84 | $39.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $107.15 Typical High $147.91 | Professional | 54 · Surgery only | $100.00 | $107.15 | $147.91 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $19.95 | $21.38 | $29.51 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $13.49 | $14.45 | $19.95 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $100.00 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $93.33 | $100.00 | $138.04 |
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· 37th of 51
$162
AK $525KY $138
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.