How much rates vary
Facilitymedian $275 · 10th to 90th $120 to $933Professionalmedian $427 · 10th to 90th $316 to $550
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 $416.87 Median $436.52 Typical High $4,897.79 | Facility | None | $416.87 | $436.52 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $446.68 | Professional | None | $416.87 | $436.52 | $446.68 |
BCBS Michigan Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $501.19 | Facility | None | $269.15 | $275.42 | $501.19 |
BCBS Michigan Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $676.08 | Professional | None | $426.58 | $478.63 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $758.58 | Professional | None | $229.09 | $346.74 | $758.58 |
Health Alliance Plan Setting Facility Modifier None Typical Low $114.82 Median $794.33 Typical High $4,897.79 | Facility | None | $114.82 | $794.33 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $446.68 | Professional | None | $316.23 | $416.87 | $446.68 |
Priority Health Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $588.84 | Professional | None | $218.78 | $269.15 | $588.84 |
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 $316.23 Median $363.08 Typical High $436.52 | Professional | None | $316.23 | $363.08 | $436.52 |
13 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 $208.93 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $83.18 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $331.13 | Professional | 54 · Surgery only | $316.23 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $44.67 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $309.03 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | 50 · Both sides | $724.44 | $831.76 | $831.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $213.80 | $218.78 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $85.11 | $87.10 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $331.13 | Professional | 54 · Surgery only | $309.03 | $323.59 | $331.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $66.07 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $43.65 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $309.03 |
Where Michigan sits
The same service costs 7.4 times more in Hawaii 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.
Physician feeFacility fee
HI $3,255FL $440
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.