How much rates vary
Facilitymedian $204 · 10th to 90th $135 to $912Professionalmedian $389 · 10th to 90th $269 to $479
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 $380.19 Median $416.87 Typical High $4,897.79 | Facility | None | $380.19 | $416.87 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | None | $371.54 | $398.11 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
BCBS Michigan Setting Facility Modifier None Typical Low $181.97 Median $186.21 Typical High $316.23 | Facility | None | $181.97 | $186.21 | $316.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $75.86 Median $446.68 Typical High $562.34 | Professional | None | $75.86 | $446.68 | $562.34 |
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 $234.42 Median $331.13 Typical High $549.54 | Professional | None | $234.42 | $331.13 | $549.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $288.40 Median $512.86 Typical High $4,897.79 | Facility | None | $288.40 | $512.86 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $436.52 | Professional | None | $309.03 | $398.11 | $436.52 |
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 $229.09 Median $309.03 Typical High $478.63 | Professional | None | $229.09 | $309.03 | $478.63 |
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 $302.00 Median $338.84 Typical High $398.11 | Professional | None | $302.00 | $338.84 | $398.11 |
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 $190.55 Median $199.53 Typical High $208.93 | Professional | 52 · Reduced service | $190.55 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $288.40 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $41.69 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $288.40 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $194.98 Typical High $204.17 | Professional | 52 · Reduced service | $190.55 | $194.98 | $204.17 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $79.43 | $83.18 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $281.84 | $295.12 | $309.03 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $61.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $40.74 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $275.42 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $263.03 | $275.42 | $288.40 |
Where Michigan sits
The same service costs 5.5 times more in Alaska than in Texas. 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· 23rd of 51
$389
AK $1,230TX $224
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.