How much rates vary
Facilitymedian $141 · 10th to 90th $78 to $513Professionalmedian $229 · 10th to 90th $120 to $309
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 $158.49 Median $257.04 Typical High $4,897.79 | Facility | None | $158.49 | $257.04 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $269.15 | Professional | None | $151.36 | $204.17 | $269.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $144.54 | Facility | None | $77.62 | $77.62 | $144.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $35.48 Median $186.21 Typical High $354.81 | Professional | None | $35.48 | $186.21 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $316.23 | Professional | None | $123.03 | $186.21 | $316.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $616.60 | Facility | None | $128.82 | $213.80 | $616.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $323.59 | Professional | None | $154.88 | $263.03 | $323.59 |
Priority Health Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $309.03 | Professional | None | $112.20 | $169.82 | $309.03 |
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 $125.89 Median $204.17 Typical High $288.40 | Professional | None | $125.89 | $204.17 | $288.40 |
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 $75.86 Median $100.00 Typical High $131.83 | Professional | 52 · Reduced service | $75.86 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $30.90 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $151.36 Typical High $199.53 | Professional | 54 · Surgery only | $114.82 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.20 Typical High $39.81 | Professional | 55 · Aftercare only | $22.91 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.95 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.14 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $141.25 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $107.15 | $141.25 | $186.21 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $91.20 Typical High $134.90 | Professional | 52 · Reduced service | $77.62 | $91.20 | $134.90 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $30.90 | $32.36 | $53.70 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $141.25 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $141.25 | $204.17 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $40.74 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.49 | $16.22 | $26.92 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $112.20 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $109.65 | $112.20 | $190.55 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$209
AK $501KY $112
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.