How much rates vary
Facilitymedian $741 · 10th to 90th $178 to $1,778Professionalmedian $186 · 10th to 90th $126 to $245
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 $173.78 Median $223.87 Typical High $2,884.03 | Facility | None | $173.78 | $223.87 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $234.42 | Professional | None | $165.96 | $199.53 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | None | $138.04 | $138.04 | $181.97 |
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 $30.20 Median $154.88 Typical High $239.88 | Professional | None | $30.20 | $154.88 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $120.23 Median $151.36 Typical High $218.78 | Professional | None | $120.23 | $151.36 | $218.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $173.78 Median $281.84 Typical High $6,918.31 | Facility | None | $173.78 | $281.84 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $251.19 | Professional | None | $169.82 | $218.78 | $251.19 |
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 $123.03 Median $151.36 Typical High $218.78 | Professional | None | $123.03 | $151.36 | $218.78 |
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 $151.36 Median $190.55 Typical High $234.42 | Professional | None | $151.36 | $190.55 | $234.42 |
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 $87.10 Median $87.10 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $44.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $123.03 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $120.23 | $123.03 | $158.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 52 · Reduced service | $85.11 | $85.11 | $112.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 53 · Discontinued | $33.88 | $33.88 | $44.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $165.96 | Professional | 54 · Surgery only | $128.82 | $128.82 | $165.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $33.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $22.39 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $154.88 |
Where Michigan sits
The same service costs 3.9 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· 31st of 51
$191
AK $603KY $155
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.