How much rates vary
Facilitymedian $1,175 · 10th to 90th $363 to $2,455Professionalmedian $302 · 10th to 90th $191 to $447
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 $251.19 Median $363.08 Typical High $4,897.79 | Facility | None | $251.19 | $363.08 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $380.19 | Professional | None | $251.19 | $295.12 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $2,041.74 | Facility | None | $1,174.90 | $1,202.26 | $2,041.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $56.23 Median $281.84 Typical High $512.86 | Professional | None | $56.23 | $281.84 | $512.86 |
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 $165.96 Median $239.88 Typical High $346.74 | Professional | None | $165.96 | $239.88 | $346.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $338.84 Median $776.25 Typical High $4,897.79 | Facility | None | $338.84 | $776.25 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $416.87 | Professional | None | $251.19 | $363.08 | $416.87 |
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 $173.78 Median $239.88 Typical High $346.74 | Professional | None | $173.78 | $239.88 | $346.74 |
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 $218.78 Median $309.03 Typical High $389.05 | Professional | None | $218.78 | $309.03 | $389.05 |
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 $125.89 Median $131.83 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $199.53 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $257.04 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $128.82 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $128.82 | $177.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $50.12 | $51.29 | $72.44 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $186.21 | $194.98 | $269.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $37.15 | $38.90 | $53.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $36.31 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $181.97 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $173.78 | $181.97 | $251.19 |
Where Michigan sits
The same service costs 3.6 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· 28th of 51
$316
AK $851KY $234
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.