How much rates vary
Facilitymedian $309 · 10th to 90th $120 to $794Professionalmedian $170 · 10th to 90th $112 to $219
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 $165.96 Median $213.80 Typical High $4,897.79 | Facility | None | $165.96 | $213.80 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $218.78 | Professional | None | $147.91 | $177.83 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | None | $104.71 | $123.03 | $169.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $309.03 Median $316.23 Typical High $549.54 | Facility | None | $309.03 | $316.23 | $549.54 |
BCBS Michigan Setting Professional Modifier None Typical Low $28.84 Median $169.82 Typical High $257.04 | Professional | None | $28.84 | $169.82 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $194.98 | Professional | None | $138.04 | $144.54 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $288.40 | Professional | None | $100.00 | $162.18 | $288.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $48.98 Median $346.74 Typical High $1,584.89 | Facility | None | $48.98 | $346.74 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $218.78 | Professional | None | $154.88 | $181.97 | $218.78 |
Priority Health Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $213.80 | Professional | None | $100.00 | $147.91 | $213.80 |
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 $141.25 Median $177.83 Typical High $204.17 | Professional | None | $141.25 | $177.83 | $204.17 |
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 $81.28 Median $85.11 Typical High $102.33 | Professional | 52 · Reduced service | $81.28 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $32.36 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $128.82 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $112.20 | $120.23 | $144.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $83.18 | $102.33 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $31.62 | $33.11 | $40.74 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $123.03 | $154.88 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $25.12 | $30.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.85 | $16.60 | $20.42 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $112.20 | $114.82 | $144.54 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 34th of 51
$170
AK $501FL $129
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.