How much rates vary
Facilitymedian $282 · 10th to 90th $200 to $1,148Professionalmedian $214 · 10th to 90th $126 to $324
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 $177.83 Median $269.15 Typical High $4,897.79 | Facility | None | $177.83 | $269.15 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $269.15 | Professional | None | $177.83 | $199.53 | $269.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $354.81 | Facility | None | $199.53 | $204.17 | $354.81 |
BCBS Michigan Setting Professional Modifier None Typical Low $33.88 Median $199.53 Typical High $380.19 | Professional | None | $33.88 | $199.53 | $380.19 |
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 $123.03 Median $169.82 Typical High $239.88 | Professional | None | $123.03 | $169.82 | $239.88 |
Health Alliance Plan Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $2,884.03 | Facility | None | $181.97 | $275.42 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $302.00 | Professional | None | $173.78 | $263.03 | $302.00 |
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 $169.82 Typical High $239.88 | Professional | None | $123.03 | $169.82 | $239.88 |
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 $154.88 Median $218.78 Typical High $281.84 | Professional | None | $154.88 | $218.78 | $281.84 |
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 $89.13 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $89.13 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $53.70 | Professional | 53 · Discontinued | $35.48 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $131.83 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $26.92 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $123.03 | $138.04 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $95.50 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $95.50 | $131.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.02 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $38.02 | $52.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $144.54 | $199.53 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $39.81 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $39.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $26.30 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $186.21 |
Where Michigan sits
The same service costs 3.4 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
$224
AK $603KY $178
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.