How much rates vary
Facilitymedian $200 · 10th to 90th $126 to $708Professionalmedian $234 · 10th to 90th $145 to $302
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 $181.97 Median $275.42 Typical High $4,897.79 | Facility | None | $181.97 | $275.42 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $275.42 | Professional | None | $181.97 | $213.80 | $275.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $186.21 Median $190.55 Typical High $331.13 | Facility | None | $186.21 | $190.55 | $331.13 |
BCBS Michigan Setting Professional Modifier None Typical Low $29.51 Median $154.88 Typical High $281.84 | Professional | None | $29.51 | $154.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $245.47 | Professional | None | $123.03 | $173.78 | $245.47 |
Health Alliance Plan Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $4,073.80 | Facility | None | $154.88 | $269.15 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $309.03 | Professional | None | $177.83 | $269.15 | $309.03 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $245.47 | Professional | None | $123.03 | $173.78 | $245.47 |
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 $165.96 Median $229.09 Typical High $288.40 | Professional | None | $165.96 | $229.09 | $288.40 |
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 $91.20 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $151.36 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $141.25 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $141.25 | $190.55 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $89.13 | $97.72 | $134.90 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $35.48 | $39.81 | $54.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $147.91 | $204.17 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $29.51 | $40.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.78 | $19.95 | $26.92 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $138.04 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $138.04 | $190.55 |
Where Michigan sits
The same service costs 3.5 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· 27th of 51
$229
AK $617KY $178
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.