How much rates vary
Facilitymedian $302 · 10th to 90th $120 to $813Professionalmedian $138 · 10th to 90th $95 to $174
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 $138.04 Median $173.78 Typical High $2,884.03 | Facility | None | $138.04 | $173.78 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | None | $123.03 | $144.54 | $181.97 |
BCBS Michigan Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $537.03 | Facility | None | $302.00 | $309.03 | $537.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $17.78 Median $109.65 Typical High $162.18 | Professional | None | $17.78 | $109.65 | $162.18 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $295.12 | Professional | None | $81.28 | $120.23 | $295.12 |
Health Alliance Plan Setting Facility Modifier None Typical Low $102.33 Median $173.78 Typical High $3,548.13 | Facility | None | $102.33 | $173.78 | $3,548.13 |
Health Alliance Plan Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $181.97 | Professional | None | $128.82 | $147.91 | $181.97 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $234.42 | Professional | None | $74.13 | $97.72 | $234.42 |
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 $107.15 Median $131.83 Typical High $165.96 | Professional | None | $107.15 | $131.83 | $165.96 |
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 $67.61 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $67.61 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $26.92 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | 54 · Surgery only | $100.00 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $26.30 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $97.72 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $93.33 | $97.72 | $123.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $66.07 | $69.18 | $87.10 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $26.30 | $27.54 | $34.67 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $100.00 | $102.33 | $128.82 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $20.42 | $25.70 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.18 | $13.80 | $17.38 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $95.50 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $93.33 | $95.50 | $120.23 |
Where Michigan sits
The same service costs 4.0 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· 33rd of 51
$141
AK $407FL $102
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.