How much rates vary
Facilitymedian $174 · 10th to 90th $126 to $955Professionalmedian $437 · 10th to 90th $214 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 $251.19 Median $436.52 Typical High $4,897.79 | Facility | None | $251.19 | $436.52 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $436.52 | Professional | None | $251.19 | $323.59 | $436.52 |
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 $141.25 Median $229.09 Typical High $467.74 | Professional | None | $141.25 | $229.09 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $478.63 | Professional | None | $158.49 | $281.84 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $245.47 Median $1,230.27 Typical High $4,897.79 | Facility | None | $245.47 | $1,230.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $588.84 | Professional | None | $245.47 | $446.68 | $588.84 |
Priority Health Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $446.68 | Professional | None | $177.83 | $269.15 | $446.68 |
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 $245.47 Median $398.11 Typical High $549.54 | Professional | None | $245.47 | $398.11 | $549.54 |
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 $125.89 Median $162.18 Typical High $218.78 | Professional | 52 · Reduced service | $125.89 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $87.10 | Professional | 53 · Discontinued | $51.29 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $190.55 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $48.98 Typical High $66.07 | Professional | 55 · Aftercare only | $38.02 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $25.12 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $177.83 | $229.09 | $309.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $123.03 | $162.18 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $64.57 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $239.88 Typical High $331.13 | Professional | 54 · Surgery only | $186.21 | $239.88 | $331.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $66.07 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $66.07 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $173.78 | $223.87 | $309.03 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 19th of 51
$407
AK $1,000TX $219
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.