How much rates vary
Facilitymedian $186 · 10th to 90th $120 to $741Professionalmedian $302 · 10th to 90th $209 to $457
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 $295.12 Median $338.84 Typical High $4,897.79 | Facility | None | $295.12 | $338.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $338.84 | Professional | None | $194.98 | $257.04 | $338.84 |
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 $93.33 Median $371.54 Typical High $524.81 | Professional | None | $93.33 | $371.54 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $436.52 | Professional | None | $181.97 | $281.84 | $436.52 |
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 $208.93 Median $302.00 Typical High $346.74 | Professional | None | $208.93 | $302.00 | $346.74 |
Priority Health Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $380.19 | Professional | None | $169.82 | $269.15 | $380.19 |
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 $245.47 Median $288.40 Typical High $331.13 | Professional | None | $245.47 | $288.40 | $331.13 |
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 $147.91 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $208.93 | $213.80 | $239.88 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $144.54 | $151.36 | $169.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $57.54 | $60.26 | $67.61 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $257.04 | Professional | 54 · Surgery only | $218.78 | $223.87 | $257.04 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $51.29 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $33.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $208.93 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $204.17 | $208.93 | $239.88 |
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· 31st of 51
$302
AK $955UT $186
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.