How much rates vary
Facilitymedian $288 · 10th to 90th $151 to $891Professionalmedian $257 · 10th to 90th $155 to $398
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 $199.53 Median $323.59 Typical High $2,884.03 | Facility | None | $199.53 | $323.59 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $338.84 | Professional | None | $199.53 | $251.19 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $199.53 | Professional | None | $144.54 | $144.54 | $199.53 |
BCBS Michigan Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $776.25 | Facility | None | $251.19 | $323.59 | $776.25 |
BCBS Michigan Setting Professional Modifier None Typical Low $43.65 Median $229.09 Typical High $467.74 | Professional | None | $43.65 | $229.09 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $354.81 | Professional | None | $144.54 | $223.87 | $354.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $190.55 Median $331.13 Typical High $1,122.02 | Facility | None | $190.55 | $331.13 | $1,122.02 |
Health Alliance Plan Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $354.81 | Professional | None | $194.98 | $302.00 | $354.81 |
Priority Health Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $346.74 | Professional | None | $144.54 | $223.87 | $346.74 |
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 $190.55 Median $257.04 Typical High $331.13 | Professional | None | $190.55 | $257.04 | $331.13 |
13 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 $100.00 Median $120.23 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $23.99 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $229.09 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 59 · Distinct service | $190.55 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $117.49 Typical High $162.18 | Professional | 52 · Reduced service | $97.72 | $117.49 | $162.18 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $47.86 | $66.07 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $177.83 | $245.47 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $35.48 Typical High $48.98 | Professional | 55 · Aftercare only | $29.51 | $35.48 | $48.98 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $32.36 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $165.96 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $165.96 | $229.09 |
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· 34th of 51
$257
AK $692KY $204
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.