How much rates vary
Facilitymedian $135 · 10th to 90th $102 to $692Professionalmedian $129 · 10th to 90th $81 to $204
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 $131.83 Median $154.88 Typical High $4,897.79 | Facility | None | $131.83 | $154.88 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $154.88 | Professional | None | $81.28 | $114.82 | $154.88 |
BCBS Michigan Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $190.55 | Facility | None | $102.33 | $102.33 | $190.55 |
BCBS Michigan Setting Professional Modifier None Typical Low $31.62 Median $169.82 Typical High $239.88 | Professional | None | $31.62 | $169.82 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $199.53 | Professional | None | $85.11 | $125.89 | $199.53 |
Health Alliance Plan Setting Facility Modifier None Typical Low $85.11 Median $275.42 Typical High $4,897.79 | Facility | None | $85.11 | $275.42 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $151.36 | Professional | None | $87.10 | $128.82 | $151.36 |
Priority Health Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $173.78 | Professional | None | $74.13 | $120.23 | $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 $109.65 Median $123.03 Typical High $147.91 | Professional | None | $109.65 | $123.03 | $147.91 |
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 $66.07 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $66.07 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $26.92 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $100.00 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.18 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $97.72 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $93.33 | $97.72 | $107.15 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 50 · Both sides | $257.04 | $309.03 | $309.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $66.07 | $75.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $26.30 | $30.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $100.00 | $112.20 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $22.91 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $15.14 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $89.13 | $93.33 | $104.71 |
Where Michigan sits
The same service costs 4.5 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· 32nd of 51
$129
AK $427FL $95.50
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.