How much rates vary
Facilitymedian $2,344 · 10th to 90th $282 to $4,786Professionalmedian $234 · 10th to 90th $191 to $302
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 $281.84 Typical High $4,073.80 | Facility | None | $218.78 | $281.84 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | None | $204.17 | $245.47 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $229.09 | Professional | None | $173.78 | $181.97 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,344.23 Median $2,398.83 Typical High $4,073.80 | Facility | None | $2,344.23 | $2,398.83 | $4,073.80 |
BCBS Michigan Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $295.12 | Professional | None | $181.97 | $204.17 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $281.84 | Professional | None | $147.91 | $190.55 | $281.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $223.87 Median $1,071.52 Typical High $5,248.07 | Facility | None | $223.87 | $1,071.52 | $5,248.07 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $309.03 | Professional | None | $208.93 | $269.15 | $309.03 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | None | $147.91 | $194.98 | $281.84 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $295.12 | Professional | None | $190.55 | $234.42 | $295.12 |
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 $107.15 Median $109.65 Typical High $141.25 | Professional | 52 · Reduced service | $107.15 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 53 · Discontinued | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $162.18 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $154.88 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $151.36 | $154.88 | $194.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $104.71 | $138.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $41.69 | $54.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $154.88 | $204.17 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $40.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $27.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $144.54 | $144.54 | $190.55 |
Where Michigan sits
The same service costs 4.7 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· 29th of 51
$251
AK $871KY $186
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.