How much rates vary
Facilitymedian $174 · 10th to 90th $126 to $617Professionalmedian $186 · 10th to 90th $117 to $245
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 $144.54 Median $223.87 Typical High $4,897.79 | Facility | None | $144.54 | $223.87 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $234.42 | Professional | None | $144.54 | $186.21 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $23.44 Median $125.89 Typical High $229.09 | Professional | None | $23.44 | $125.89 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $199.53 | Professional | None | $100.00 | $141.25 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $181.97 Median $512.86 Typical High $4,897.79 | Facility | None | $181.97 | $512.86 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $257.04 | Professional | None | $141.25 | $223.87 | $257.04 |
Priority Health Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $199.53 | Professional | None | $100.00 | $141.25 | $199.53 |
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 $134.90 Median $186.21 Typical High $234.42 | Professional | None | $134.90 | $186.21 | $234.42 |
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 $72.44 Median $81.28 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.11 Typical High $44.67 | Professional | 53 · Discontinued | $28.84 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $123.03 Typical High $169.82 | Professional | 54 · Surgery only | $107.15 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $114.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $100.00 | $114.82 | $158.49 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $81.28 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $81.28 | $112.20 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $32.36 | $44.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $120.23 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $120.23 | $165.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.99 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $23.99 | $33.11 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $22.39 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $154.88 |
Where Michigan sits
The same service costs 3.3 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· 30th of 51
$182
AK $490MD $148
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.