How much rates vary
Facilitymedian $178 · 10th to 90th $120 to $631Professionalmedian $251 · 10th to 90th $162 to $380
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 $245.47 Median $316.23 Typical High $4,897.79 | Facility | None | $245.47 | $316.23 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $275.42 | Professional | None | $147.91 | $208.93 | $275.42 |
BCBS Michigan Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $269.15 | Facility | None | $147.91 | $147.91 | $269.15 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $446.68 | Professional | None | $186.21 | $380.19 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $363.08 | Professional | None | $154.88 | $234.42 | $363.08 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $316.23 Typical High $2,884.03 | Facility | None | $85.11 | $316.23 | $2,884.03 |
Health Alliance Plan Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $295.12 | Professional | None | $162.18 | $251.19 | $295.12 |
Priority Health Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $323.59 | Professional | None | $141.25 | $223.87 | $323.59 |
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 $208.93 Median $234.42 Typical High $275.42 | Professional | None | $208.93 | $234.42 | $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 $123.03 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $123.03 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $208.93 | Professional | 54 · Surgery only | $186.21 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $41.69 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $194.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $125.89 | $138.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $54.95 | Professional | 53 · Discontinued | $48.98 | $50.12 | $54.95 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $190.55 | $208.93 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $41.69 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $27.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $169.82 | $177.83 | $194.98 |
Where Michigan sits
The same service costs 4.8 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· 28th of 51
$251
AK $794FL $166
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.