How much rates vary
Facilitymedian $339 · 10th to 90th $229 to $1,905Professionalmedian $302 · 10th to 90th $200 to $407
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 $204.17 Median $309.03 Typical High $4,897.79 | Facility | None | $204.17 | $309.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $309.03 | Professional | None | $204.17 | $257.04 | $309.03 |
BCBS Michigan Setting Facility Modifier None Typical Low $229.09 Median $234.42 Typical High $398.11 | Facility | None | $229.09 | $234.42 | $398.11 |
BCBS Michigan Setting Professional Modifier None Typical Low $53.70 Median $407.38 Typical High $407.38 | Professional | None | $53.70 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | None | $169.82 | $234.42 | $354.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $229.09 Median $676.08 Typical High $4,897.79 | Facility | None | $229.09 | $676.08 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $371.54 | Professional | None | $199.53 | $302.00 | $371.54 |
Priority Health Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $354.81 | Professional | None | $169.82 | $234.42 | $354.81 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $363.08 | Professional | None | $208.93 | $281.84 | $363.08 |
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 $102.33 Median $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $177.83 | $213.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $107.15 Typical High $151.36 | Professional | 52 · Reduced service | $100.00 | $107.15 | $151.36 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $60.26 | Professional | 53 · Discontinued | $39.81 | $42.66 | $60.26 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $162.18 | $229.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $45.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $30.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $151.36 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $151.36 | $213.80 |
Where Michigan sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$302
AK $759TX $214
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.