How much rates vary
Facilitymedian $162 · 10th to 90th $107 to $617Professionalmedian $93 · 10th to 90th $45 to $120
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 $83.18 Median $114.82 Typical High $4,897.79 | Facility | None | $83.18 | $114.82 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $120.23 | Professional | None | $83.18 | $95.50 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $13.49 Median $67.61 Typical High $117.49 | Professional | None | $13.49 | $67.61 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $104.71 | Professional | None | $54.95 | $77.62 | $104.71 |
Health Alliance Plan Setting Facility Modifier None Typical Low $100.00 Median $251.19 Typical High $4,897.79 | Facility | None | $100.00 | $251.19 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $125.89 | Professional | None | $81.28 | $109.65 | $125.89 |
Priority Health Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $104.71 | Professional | None | $57.54 | $74.13 | $104.71 |
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 $72.44 Median $93.33 Typical High $117.49 | Professional | None | $72.44 | $93.33 | $117.49 |
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 $41.69 Median $42.66 Typical High $57.54 | Professional | 52 · Reduced service | $41.69 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.98 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $64.57 Typical High $87.10 | Professional | 54 · Surgery only | $63.10 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $17.38 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.51 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.32 | $8.51 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $60.26 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $58.88 | $60.26 | $81.28 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $41.69 Typical High $57.54 | Professional | 52 · Reduced service | $40.74 | $41.69 | $57.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.60 Typical High $22.91 | Professional | 53 · Discontinued | $16.22 | $16.60 | $22.91 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $63.10 Typical High $87.10 | Professional | 54 · Surgery only | $61.66 | $63.10 | $87.10 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $17.38 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $11.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $58.88 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $57.54 | $58.88 | $81.28 |
Where Michigan sits
The same service costs 3.8 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· 29th of 51
$97.72
AK $288KY $75.86
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.