How much rates vary
Facilitymedian $708 · 10th to 90th $339 to $1,549Professionalmedian $269 · 10th to 90th $219 to $331
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 $251.19 Median $338.84 Typical High $4,897.79 | Facility | None | $251.19 | $338.84 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $331.13 | Professional | None | $251.19 | $257.04 | $331.13 |
BCBS Michigan Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $1,230.27 | Facility | None | $707.95 | $724.44 | $1,230.27 |
BCBS Michigan Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $281.84 | Professional | None | $177.83 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $467.74 | Professional | None | $158.49 | $257.04 | $467.74 |
Health Alliance Plan Setting Facility Modifier None Typical Low $323.59 Median $575.44 Typical High $4,897.79 | Facility | None | $323.59 | $575.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $338.84 | Professional | None | $229.09 | $295.12 | $338.84 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $371.54 | Professional | None | $144.54 | $245.47 | $371.54 |
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 $204.17 Median $245.47 Typical High $295.12 | Professional | None | $204.17 | $245.47 | $295.12 |
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 $125.89 Median $128.82 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $66.07 | Professional | 53 · Discontinued | $50.12 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $37.15 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $234.42 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $125.89 Typical High $165.96 | Professional | 52 · Reduced service | $123.03 | $125.89 | $165.96 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $48.98 | $51.29 | $67.61 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $190.55 Typical High $251.19 | Professional | 54 · Surgery only | $181.97 | $190.55 | $251.19 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $50.12 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $50.12 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $33.88 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $177.83 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $169.82 | $177.83 | $234.42 |
Where Michigan sits
The same service costs 4.3 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· 34th of 51
$269
AK $912KY $214
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.