How much rates vary
Facilitymedian $251 · 10th to 90th $174 to $1,549Professionalmedian $240 · 10th to 90th $178 to $339
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 $204.17 Median $288.40 Typical High $4,897.79 | Facility | None | $204.17 | $288.40 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $208.93 Typical High $288.40 | Professional | None | $204.17 | $208.93 | $288.40 |
BCBS Michigan Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $302.00 | Facility | None | $173.78 | $173.78 | $302.00 |
BCBS Michigan Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $338.84 | Professional | None | $141.25 | $239.88 | $338.84 |
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 $141.25 Median $213.80 Typical High $380.19 | Professional | None | $141.25 | $213.80 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $177.83 Median $549.54 Typical High $4,897.79 | Facility | None | $177.83 | $549.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $295.12 | Professional | None | $208.93 | $275.42 | $295.12 |
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 $128.82 Median $204.17 Typical High $302.00 | Professional | None | $128.82 | $204.17 | $302.00 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,691.53 | Facility | None | $288.40 | $426.58 | $2,691.53 |
United Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $275.42 | Professional | None | $186.21 | $223.87 | $275.42 |
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 $100.00 Median $104.71 Typical High $144.54 | Professional | 52 · Reduced service | $100.00 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $57.54 | Professional | 53 · Discontinued | $40.74 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $151.36 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $28.84 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $141.25 | $147.91 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $104.71 Typical High $147.91 | Professional | 52 · Reduced service | $102.33 | $104.71 | $147.91 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $41.69 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $41.69 | $58.88 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $158.49 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $158.49 | $218.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $43.65 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.89 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $20.89 | $29.51 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $147.91 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $147.91 | $204.17 |
Where Michigan sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 29th of 51
$240
AK $646FL $174
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.