How much rates vary
Facilitymedian $316 · 10th to 90th $120 to $977Professionalmedian $363 · 10th to 90th $245 to $537
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 $263.03 Median $436.52 Typical High $4,897.79 | Facility | None | $263.03 | $436.52 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $446.68 | Professional | None | $263.03 | $338.84 | $446.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $537.03 | Facility | None | $309.03 | $316.23 | $537.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $645.65 | Professional | None | $190.55 | $302.00 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $478.63 | Professional | None | $181.97 | $288.40 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $67.61 Median $467.74 Typical High $4,073.80 | Facility | None | $67.61 | $467.74 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $489.78 | Professional | None | $257.04 | $436.52 | $489.78 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $467.74 | Professional | None | $181.97 | $309.03 | $467.74 |
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 $239.88 Median $346.74 Typical High $467.74 | Professional | None | $239.88 | $346.74 | $467.74 |
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 $131.83 Median $162.18 Typical High $218.78 | Professional | 52 · Reduced service | $131.83 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $199.53 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $66.07 | Professional | 55 · Aftercare only | $39.81 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $309.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $162.18 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $89.13 | Professional | 53 · Discontinued | $51.29 | $64.57 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $239.88 | $331.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $67.61 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $309.03 |
Where Michigan sits
The same service costs 3.5 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· 25th of 51
$363
AK $891MD $257
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.