How much rates vary
Facilitymedian $257 · 10th to 90th $182 to $955Professionalmedian $269 · 10th to 90th $182 to $389
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 $229.09 Median $380.19 Typical High $4,897.79 | Facility | None | $229.09 | $380.19 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $380.19 | Professional | None | $229.09 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $131.83 Typical High $190.55 | Professional | 52 · Reduced service | $114.82 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $53.70 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $288.40 | Professional | 54 · Surgery only | $173.78 | $194.98 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $40.74 Typical High $57.54 | Professional | 55 · Aftercare only | $34.67 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $269.15 |
BCBS Michigan Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $316.23 | Facility | None | $181.97 | $181.97 | $316.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $302.00 | Professional | None | $186.21 | $288.40 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $478.63 | Professional | None | $138.04 | $251.19 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $229.09 Median $389.05 Typical High $4,897.79 | Facility | None | $229.09 | $389.05 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $194.98 | Professional | 52 · Reduced service | $114.82 | $123.03 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $46.77 | $50.12 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $181.97 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $58.88 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $58.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $38.90 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $38.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $169.82 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $169.82 | $275.42 |
Priority Health Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $436.52 | Professional | None | $138.04 | $239.88 | $436.52 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,089.30 | Facility | None | $288.40 | $426.58 | $2,089.30 |
United Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $354.81 | Professional | None | $173.78 | $229.09 | $354.81 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 51 · Multiple procedures + 59 · Distinct service Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 51 · Multiple procedures + 59 · Distinct service | $186.21 | $186.21 | $186.21 |
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· 32nd of 51
$269
AK $741KY $166
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.