How much rates vary
Facilitymedian $186 · 10th to 90th $120 to $708Professionalmedian $204 · 10th to 90th $78 to $263
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 $154.88 Median $239.88 Typical High $4,897.79 | Facility | None | $154.88 | $239.88 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $239.88 | Professional | None | $154.88 | $177.83 | $239.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $302.00 | Facility | None | $169.82 | $173.78 | $302.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $27.54 Median $87.10 Typical High $245.47 | Professional | None | $27.54 | $87.10 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $213.80 | Professional | None | $107.15 | $151.36 | $213.80 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $512.86 Typical High $4,897.79 | Facility | None | $85.11 | $512.86 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $275.42 | Professional | None | $151.36 | $239.88 | $275.42 |
Priority Health Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $213.80 | Professional | None | $107.15 | $151.36 | $213.80 |
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 $199.53 Typical High $251.19 | Professional | None | $144.54 | $199.53 | $251.19 |
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 $77.62 Median $89.13 Typical High $120.23 | Professional | 52 · Reduced service | $77.62 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $47.86 | Professional | 53 · Discontinued | $30.90 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $117.49 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $36.31 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $123.03 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $109.65 | $123.03 | $169.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $87.10 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $87.10 | $120.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $34.67 | $47.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $128.82 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $128.82 | $177.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $35.48 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $17.38 | $23.99 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $165.96 |
Where Michigan sits
The same service costs 3.5 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· 28th of 51
$200
AK $525MD $151
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.