How much rates vary
Facilitymedian $151 · 10th to 90th $107 to $1,202Professionalmedian $525 · 10th to 90th $112 to $589
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 $524.81 Median $2,041.74 Typical High $4,897.79 | Facility | None | $524.81 | $2,041.74 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $239.88 | Facility | None | $128.82 | $131.83 | $239.88 |
BCBS Michigan Setting Professional Modifier None Typical Low $95.50 Median $562.34 Typical High $562.34 | Professional | None | $95.50 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $794.33 | Professional | None | $316.23 | $446.68 | $794.33 |
Health Alliance Plan Setting Facility Modifier None Typical Low $60.26 Median $1,096.48 Typical High $4,897.79 | Facility | None | $60.26 | $1,096.48 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $588.84 | Professional | None | $416.87 | $524.81 | $588.84 |
Priority Health Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $676.08 | Professional | None | $316.23 | $436.52 | $676.08 |
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 $457.09 Median $562.34 Typical High $630.96 | Professional | None | $457.09 | $562.34 | $630.96 |
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 $263.03 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $389.05 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $371.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $104.71 | $104.71 | $104.71 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Where Michigan sits
The same service costs 4.2 times more in Wyoming 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· 24th of 51
$525
WY $1,288UT $309
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.