How much rates vary
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 $446.68 Median $446.68 Typical High $6,918.31 | Facility | None | $446.68 | $446.68 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,995.26 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $131.83 Median $478.63 Typical High $776.25 | Professional | None | $131.83 | $478.63 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $741.31 | Professional | None | $302.00 | $436.52 | $741.31 |
Health Alliance Plan Setting Facility Modifier None Typical Low $467.74 Median $1,584.89 Typical High $4,897.79 | Facility | None | $467.74 | $1,584.89 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $776.25 | Professional | None | $467.74 | $562.34 | $776.25 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Priority Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $660.69 | Professional | None | $302.00 | $426.58 | $660.69 |
United Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $3,311.31 | Facility | None | $426.58 | $549.54 | $3,311.31 |
United Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $812.83 | Professional | None | $380.19 | $446.68 | $812.83 |
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 82 · Assistant surgeon, no resident Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 82 · Assistant surgeon, no resident | $47.86 | $47.86 | $47.86 |
Where Michigan sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 25th of 51
$479
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.