How much rates vary
Facilitymedian $1,995 · 10th to 90th $234 to $3,802Professionalmedian $162 · 10th to 90th $89 to $234
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 $229.09 Typical High $4,897.79 | Facility | None | $158.49 | $229.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $234.42 | Professional | None | $134.90 | $181.97 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,467.37 | Facility | None | $1,995.26 | $1,995.26 | $3,467.37 |
BCBS Michigan Setting Professional Modifier None Typical Low $27.54 Median $89.13 Typical High $169.82 | Professional | None | $27.54 | $89.13 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $288.40 | Professional | None | $120.23 | $173.78 | $288.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $97.72 Median $354.81 Typical High $6,918.31 | Facility | None | $97.72 | $354.81 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | None | $134.90 | $173.78 | $234.42 |
Priority Health Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $288.40 | Professional | None | $117.49 | $144.54 | $288.40 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $208.93 | Professional | None | $134.90 | $162.18 | $208.93 |
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 $79.43 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $79.43 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $31.62 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $125.89 Typical High $177.83 | Professional | 54 · Surgery only | $117.49 | $125.89 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $23.99 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $117.49 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $109.65 | $117.49 | $165.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $81.28 Typical High $117.49 | Professional | 52 · Reduced service | $77.62 | $81.28 | $117.49 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $32.36 Typical High $46.77 | Professional | 53 · Discontinued | $31.62 | $32.36 | $46.77 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $123.03 | $173.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $24.55 | $34.67 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.22 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.85 | $16.22 | $23.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $114.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $109.65 | $114.82 | $162.18 |
Where Michigan sits
The same service costs 3.9 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· 42nd of 51
$170
AK $550KY $141
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.