How much rates vary
Facilitymedian $162 · 10th to 90th $120 to $708Professionalmedian $224 · 10th to 90th $132 to $316
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 $158.49 Median $263.03 Typical High $4,897.79 | Facility | None | $158.49 | $263.03 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $275.42 | Professional | None | $158.49 | $194.98 | $275.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $257.04 | Facility | None | $147.91 | $147.91 | $257.04 |
BCBS Michigan Setting Professional Modifier None Typical Low $37.15 Median $173.78 Typical High $181.97 | Professional | None | $37.15 | $173.78 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $257.04 | Professional | None | $112.20 | $165.96 | $257.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $263.03 Median $707.95 Typical High $4,897.79 | Facility | None | $263.03 | $707.95 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $323.59 | Professional | None | $158.49 | $263.03 | $323.59 |
Priority Health Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | None | $112.20 | $158.49 | $251.19 |
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 $144.54 Median $223.87 Typical High $295.12 | Professional | None | $144.54 | $223.87 | $295.12 |
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 $79.43 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $147.91 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $147.91 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $39.81 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.50 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $138.04 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $112.20 | $138.04 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $95.50 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $95.50 | $131.83 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.02 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $38.02 | $52.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $144.54 Typical High $199.53 | Professional | 54 · Surgery only | $117.49 | $144.54 | $199.53 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $39.81 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.05 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $19.05 | $26.30 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $134.90 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $109.65 | $134.90 | $186.21 |
Where Michigan sits
The same service costs 3.8 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· 33rd of 51
$209
AK $603MD $158
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.