How much rates vary
Facilitymedian $661 · 10th to 90th $151 to $1,288Professionalmedian $407 · 10th to 90th $269 to $589
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 $331.13 Median $489.78 Typical High $4,897.79 | Facility | None | $331.13 | $489.78 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $512.86 | Professional | None | $331.13 | $416.87 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
BCBS Michigan Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $1,174.90 | Facility | None | $660.69 | $676.08 | $1,174.90 |
BCBS Michigan Setting Professional Modifier None Typical Low $72.44 Median $363.08 Typical High $691.83 | Professional | None | $72.44 | $363.08 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $524.81 | Professional | None | $229.09 | $346.74 | $524.81 |
Health Alliance Plan Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $4,073.80 | Facility | None | $223.87 | $416.87 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $537.03 | Professional | None | $323.59 | $478.63 | $537.03 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $524.81 | Professional | None | $229.09 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,258.93 | Facility | None | $91.20 | $177.83 | $1,258.93 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $524.81 | Professional | None | $323.59 | $416.87 | $524.81 |
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 $165.96 Median $181.97 Typical High $245.47 | Professional | 52 · Reduced service | $165.96 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $269.15 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $346.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $177.83 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $177.83 | $245.47 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $70.79 | $97.72 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $263.03 | $371.54 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $74.13 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $48.98 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $245.47 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $245.47 | $346.74 |
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· 31st of 51
$407
AK $1,122KY $331
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.