How much rates vary
Facilitymedian $251 · 10th to 90th $178 to $1,549Professionalmedian $182 · 10th to 90th $105 to $269
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 $144.54 Median $229.09 Typical High $4,897.79 | Facility | None | $144.54 | $229.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $229.09 | Professional | None | $144.54 | $177.83 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
BCBS Michigan Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $309.03 | Facility | None | $177.83 | $177.83 | $309.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $33.88 Median $169.82 Typical High $331.13 | Professional | None | $33.88 | $169.82 | $331.13 |
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 $144.54 Typical High $208.93 | Professional | None | $93.33 | $144.54 | $208.93 |
Health Alliance Plan Setting Facility Modifier None Typical Low $177.83 Median $478.63 Typical High $4,897.79 | Facility | None | $177.83 | $478.63 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $257.04 | Professional | None | $144.54 | $223.87 | $257.04 |
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 $102.33 Median $144.54 Typical High $208.93 | Professional | None | $102.33 | $144.54 | $208.93 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,691.53 | Facility | None | $288.40 | $426.58 | $2,691.53 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $245.47 | Professional | None | $123.03 | $181.97 | $245.47 |
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 $72.44 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $169.82 | Professional | 54 · Surgery only | $109.65 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $158.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $70.79 | $83.18 | $114.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $33.11 | $45.71 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $123.03 | $169.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $34.67 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $22.91 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $114.82 | $158.49 |
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· 34th of 51
$186
AK $501KY $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.