How much rates vary
Facilitymedian $468 · 10th to 90th $120 to $1,148Professionalmedian $240 · 10th to 90th $138 to $363
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 $173.78 Median $302.00 Typical High $2,884.03 | Facility | None | $173.78 | $302.00 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $316.23 | Professional | None | $173.78 | $234.42 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $245.47 | Professional | None | $125.89 | $186.21 | $245.47 |
BCBS Michigan Setting Facility Modifier None Typical Low $467.74 Median $478.63 Typical High $812.83 | Facility | None | $467.74 | $478.63 | $812.83 |
BCBS Michigan Setting Professional Modifier None Typical Low $39.81 Median $199.53 Typical High $436.52 | Professional | None | $39.81 | $199.53 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $331.13 | Professional | None | $125.89 | $194.98 | $331.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $67.61 Median $316.23 Typical High $2,454.71 | Facility | None | $67.61 | $316.23 | $2,454.71 |
Health Alliance Plan Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $331.13 | Professional | None | $169.82 | $281.84 | $331.13 |
Priority Health Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $323.59 | Professional | None | $125.89 | $208.93 | $323.59 |
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 $165.96 Median $234.42 Typical High $309.03 | Professional | None | $165.96 | $234.42 | $309.03 |
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 $87.10 Median $112.20 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $44.67 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $128.82 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $213.80 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $109.65 Typical High $151.36 | Professional | 52 · Reduced service | $85.11 | $109.65 | $151.36 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $60.26 | Professional | 53 · Discontinued | $33.88 | $43.65 | $60.26 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $165.96 Typical High $229.09 | Professional | 54 · Surgery only | $125.89 | $165.96 | $229.09 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $45.71 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $45.71 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $30.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $154.88 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $117.49 | $154.88 | $213.80 |
Where Michigan sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 29th of 51
$240
AK $631MD $186
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.