How much rates vary
Facilitymedian $204 · 10th to 90th $135 to $1,175Professionalmedian $479 · 10th to 90th $302 to $603
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 $331.13 Median $562.34 Typical High $4,897.79 | Facility | None | $331.13 | $562.34 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $575.44 | Professional | None | $331.13 | $380.19 | $575.44 |
BCBS Michigan Setting Facility Modifier None Typical Low $194.98 Median $199.53 Typical High $346.74 | Facility | None | $194.98 | $199.53 | $346.74 |
BCBS Michigan Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $724.44 | Professional | None | $354.81 | $489.78 | $724.44 |
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 $199.53 Median $389.05 Typical High $912.01 | Professional | None | $199.53 | $389.05 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $4,897.79 | Facility | None | $173.78 | $575.44 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $588.84 | Professional | None | $338.84 | $501.19 | $588.84 |
Priority Health Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $741.31 | Professional | None | $181.97 | $309.03 | $741.31 |
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 $269.15 Median $436.52 Typical High $562.34 | Professional | None | $269.15 | $436.52 | $562.34 |
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 $165.96 Median $190.55 Typical High $281.84 | Professional | 52 · Reduced service | $165.96 | $190.55 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $114.82 | Professional | 53 · Discontinued | $66.07 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $85.11 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $398.11 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $524.81 Typical High $1,071.52 | Professional | 50 · Both sides | $524.81 | $524.81 | $1,071.52 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $169.82 Typical High $288.40 | Professional | 52 · Reduced service | $162.18 | $169.82 | $288.40 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $114.82 | Professional | 53 · Discontinued | $66.07 | $67.61 | $114.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $257.04 | $436.52 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $87.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $57.54 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $407.38 |
Where Michigan sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 15th of 51
$468
AK $1,023MD $302
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.