How much rates vary
Facilitymedian $186 · 10th to 90th $126 to $708Professionalmedian $209 · 10th to 90th $132 to $269
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 $162.18 Median $245.47 Typical High $4,897.79 | Facility | None | $162.18 | $245.47 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $251.19 | Professional | None | $162.18 | $190.55 | $251.19 |
BCBS Michigan Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $295.12 | Facility | None | $169.82 | $173.78 | $295.12 |
BCBS Michigan Setting Professional Modifier None Typical Low $26.30 Median $131.83 Typical High $251.19 | Professional | None | $26.30 | $131.83 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $154.88 Median $512.86 Typical High $4,897.79 | Facility | None | $154.88 | $512.86 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $275.42 | Professional | None | $158.49 | $239.88 | $275.42 |
Priority Health Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $218.78 | Professional | None | $112.20 | $158.49 | $218.78 |
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 $151.36 Median $204.17 Typical High $257.04 | Professional | None | $151.36 | $204.17 | $257.04 |
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 $81.28 Median $89.13 Typical High $123.03 | Professional | 52 · Reduced service | $81.28 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $17.78 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.22 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $169.82 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $87.10 Typical High $120.23 | Professional | 52 · Reduced service | $79.43 | $87.10 | $120.23 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $47.86 | Professional | 53 · Discontinued | $31.62 | $34.67 | $47.86 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $131.83 | $181.97 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $36.31 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $23.99 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $123.03 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $123.03 | $169.82 |
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· 25th of 51
$209
AK $550MD $158
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.