How much rates vary
Facilitymedian $174 · 10th to 90th $100 to $525Professionalmedian $129 · 10th to 90th $78 to $174
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 $100.00 Median $128.82 Typical High $162.18 | Facility | None | $100.00 | $128.82 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $138.04 | Professional | None | $100.00 | $117.49 | $138.04 |
BCBS Michigan Setting Facility Modifier None Typical Low $154.88 Median $158.49 Typical High $269.15 | Facility | None | $154.88 | $158.49 | $269.15 |
BCBS Michigan Setting Professional Modifier None Typical Low $21.88 Median $109.65 Typical High $173.78 | Professional | None | $21.88 | $109.65 | $173.78 |
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 $67.61 Median $107.15 Typical High $199.53 | Professional | None | $67.61 | $107.15 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $89.13 Median $263.03 Typical High $676.08 | Facility | None | $89.13 | $263.03 | $676.08 |
Health Alliance Plan Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | None | $104.71 | $134.90 | $181.97 |
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 $61.66 Median $100.00 Typical High $173.78 | Professional | None | $61.66 | $100.00 | $173.78 |
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 $89.13 Median $114.82 Typical High $162.18 | Professional | None | $89.13 | $114.82 | $162.18 |
13 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 $50.12 Median $51.29 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.42 Typical High $26.30 | Professional | 53 · Discontinued | $19.95 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $77.62 Typical High $97.72 | Professional | 54 · Surgery only | $74.13 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $72.44 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $69.18 | $72.44 | $91.20 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $177.83 Median $223.87 Typical High $257.04 | Professional | 50 · Both sides | $177.83 | $223.87 | $257.04 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $52.48 | $67.61 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $27.54 | Professional | 53 · Discontinued | $20.42 | $20.89 | $27.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $102.33 | Professional | 54 · Surgery only | $75.86 | $83.18 | $102.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $20.42 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $13.49 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $74.13 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $70.79 | $74.13 | $95.50 |
Where Michigan sits
The same service costs 3.9 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· 26th of 51
$129
AK $324FL $83.18
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.