How much rates vary
Facilitymedian $427 · 10th to 90th $145 to $1,047Professionalmedian $363 · 10th to 90th $229 to $525
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 $288.40 Median $446.68 Typical High $4,897.79 | Facility | None | $288.40 | $446.68 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | None | $288.40 | $338.84 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | None | $162.18 | $275.42 | $275.42 |
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 $53.70 Median $338.84 Typical High $630.96 | Professional | None | $53.70 | $338.84 | $630.96 |
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 $186.21 Median $302.00 Typical High $478.63 | Professional | None | $186.21 | $302.00 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $190.55 Median $562.34 Typical High $2,884.03 | Facility | None | $190.55 | $562.34 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $501.19 | Professional | None | $281.84 | $416.87 | $501.19 |
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 $186.21 Median $302.00 Typical High $478.63 | Professional | None | $186.21 | $302.00 | $478.63 |
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 $281.84 Median $380.19 Typical High $478.63 | Professional | None | $281.84 | $380.19 | $478.63 |
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 $144.54 Median $165.96 Typical High $223.87 | Professional | 52 · Reduced service | $144.54 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $66.07 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $213.80 | $245.47 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.11 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $229.09 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $199.53 | $229.09 | $316.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $141.25 | $162.18 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $64.57 Typical High $89.13 | Professional | 53 · Discontinued | $56.23 | $64.57 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $208.93 | $245.47 | $338.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $42.66 | $48.98 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.18 | $32.36 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $229.09 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $194.98 | $229.09 | $316.23 |
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· 28th of 51
$372
AK $977MD $282
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.