How much rates vary
Facilitymedian $47 · 10th to 90th $27 to $479Professionalmedian $60 · 10th to 90th $41 to $78
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 $57.54 Median $61.66 Typical High $4,897.79 | Facility | None | $57.54 | $61.66 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $64.57 | Professional | None | $51.29 | $60.26 | $64.57 |
BCBS Michigan Setting Facility Modifier None Typical Low $26.92 Median $27.54 Typical High $47.86 | Facility | None | $26.92 | $27.54 | $47.86 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.96 Median $64.57 Typical High $87.10 | Professional | None | $10.96 | $64.57 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $70.79 | Professional | None | $37.15 | $48.98 | $70.79 |
Health Alliance Plan Setting Facility Modifier None Typical Low $57.54 Median $138.04 Typical High $4,897.79 | Facility | None | $57.54 | $138.04 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $67.61 | Professional | None | $51.29 | $61.66 | $67.61 |
Priority Health Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $70.79 | Professional | None | $37.15 | $48.98 | $70.79 |
United Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $1,202.26 | Facility | None | $89.13 | $173.78 | $1,202.26 |
United Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $67.61 | Professional | None | $50.12 | $57.54 | $67.61 |
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 $28.84 Median $29.51 Typical High $31.62 | Professional | 52 · Reduced service | $28.84 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $12.59 | Professional | 53 · Discontinued | $11.48 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | 54 · Surgery only | $43.65 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $6.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 78 · Unplanned return to OR | $40.74 | $40.74 | $43.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.90 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.30 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 54 · Surgery only | $43.65 | $43.65 | $45.71 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.33 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.17 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 78 · Unplanned return to OR | $40.74 | $40.74 | $42.66 |
Where Michigan sits
The same service costs 4.6 times more in Alaska than in New York. 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· 24th of 51
$60.26
AK $200NY $43.65
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.