How much rates vary
Facilitymedian $427 · 10th to 90th $120 to $1,096Professionalmedian $151 · 10th to 90th $87 to $204
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 $100.00 Median $173.78 Typical High $4,897.79 | Facility | None | $100.00 | $173.78 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $131.83 Typical High $181.97 | Professional | None | $100.00 | $131.83 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS Michigan Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $741.31 | Facility | None | $426.58 | $436.52 | $741.31 |
BCBS Michigan Setting Professional Modifier None Typical Low $19.95 Median $138.04 Typical High $154.88 | Professional | None | $19.95 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $204.17 | Professional | None | $69.18 | $128.82 | $204.17 |
Health Alliance Plan Setting Facility Modifier None Typical Low $165.96 Median $457.09 Typical High $4,897.79 | Facility | None | $165.96 | $457.09 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $97.72 Median $173.78 Typical High $208.93 | Professional | None | $97.72 | $173.78 | $208.93 |
Priority Health Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $204.17 | Professional | None | $69.18 | $128.82 | $204.17 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $199.53 | Professional | None | $75.86 | $134.90 | $199.53 |
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 $50.12 Median $72.44 Typical High $87.10 | Professional | 52 · Reduced service | $50.12 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $19.95 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $74.13 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $14.79 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.00 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $69.18 | $102.33 | $120.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $56.23 Typical High $87.10 | Professional | 52 · Reduced service | $48.98 | $56.23 | $87.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.39 Typical High $34.67 | Professional | 53 · Discontinued | $19.50 | $22.39 | $34.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $128.82 | Professional | 54 · Surgery only | $72.44 | $85.11 | $128.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.98 Typical High $25.70 | Professional | 55 · Aftercare only | $14.79 | $16.98 | $25.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.77 | $11.22 | $17.38 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $79.43 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $69.18 | $79.43 | $120.23 |
Where Michigan sits
The same service costs 4.5 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
$155
AK $407KY $91.20
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.