How much rates vary
Facilitymedian $182 · 10th to 90th $120 to $617Professionalmedian $257 · 10th to 90th $162 to $331
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 $263.03 Median $338.84 Typical High $4,897.79 | Facility | None | $263.03 | $338.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $302.00 | Professional | None | $147.91 | $263.03 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
BCBS Michigan Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $288.40 | Facility | None | $162.18 | $165.96 | $288.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $354.81 | Professional | None | $147.91 | $288.40 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $281.84 | Professional | None | $199.53 | $208.93 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $380.19 | Professional | None | $158.49 | $245.47 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $338.84 Typical High $2,041.74 | Facility | None | $85.11 | $338.84 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $302.00 | Professional | None | $162.18 | $257.04 | $302.00 |
Priority Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | None | $151.36 | $229.09 | $346.74 |
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 $213.80 Median $239.88 Typical High $281.84 | Professional | None | $213.80 | $239.88 | $281.84 |
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 $131.83 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $131.83 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 53 · Discontinued | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $39.81 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.30 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $190.55 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $181.97 | $190.55 | $199.53 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $134.90 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $134.90 | $144.54 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $52.48 | $53.70 | $57.54 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $194.98 | $204.17 | $213.80 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $42.66 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $28.84 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $190.55 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $181.97 | $190.55 | $199.53 |
Where Michigan sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$257
AK $871UT $170
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.