How much rates vary
Facilitymedian $162 · 10th to 90th $120 to $490Professionalmedian $132 · 10th to 90th $107 to $186
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 $109.65 Median $144.54 Typical High $4,897.79 | Facility | None | $109.65 | $144.54 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $144.54 | Professional | None | $104.71 | $117.49 | $144.54 |
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 $100.00 Median $120.23 Typical High $199.53 | Professional | None | $100.00 | $120.23 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $138.04 | Professional | None | $74.13 | $107.15 | $138.04 |
Health Alliance Plan Setting Facility Modifier None Typical Low $109.65 Median $354.81 Typical High $4,897.79 | Facility | None | $109.65 | $354.81 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $173.78 | Professional | None | $109.65 | $144.54 | $173.78 |
Priority Health Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $138.04 | Professional | None | $74.13 | $107.15 | $138.04 |
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 $104.71 Median $128.82 Typical High $162.18 | Professional | None | $104.71 | $128.82 | $162.18 |
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 $54.95 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $54.95 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $77.62 | $77.62 | $102.33 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | 52 · Reduced service | $54.95 | $54.95 | $72.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $21.88 | $28.84 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 54 · Surgery only | $81.28 | $81.28 | $107.15 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $21.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $14.45 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $75.86 | $75.86 | $100.00 |
Where Michigan sits
The same service costs 3.8 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· 21st of 51
$138
AK $380NY $100
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.