How much rates vary
Facilitymedian $389 · 10th to 90th $182 to $1,047Professionalmedian $214 · 10th to 90th $135 to $295
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 $147.91 Median $229.09 Typical High $4,897.79 | Facility | None | $147.91 | $229.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $229.09 | Professional | None | $147.91 | $173.78 | $229.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $676.08 | Facility | None | $380.19 | $389.05 | $676.08 |
BCBS Michigan Setting Professional Modifier None Typical Low $36.31 Median $275.42 Typical High $316.23 | Professional | None | $36.31 | $275.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $275.42 | Professional | None | $123.03 | $169.82 | $275.42 |
Health Alliance Plan Setting Facility Modifier None Typical Low $79.43 Median $316.23 Typical High $2,041.74 | Facility | None | $79.43 | $316.23 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $263.03 | Professional | None | $144.54 | $213.80 | $263.03 |
Priority Health Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $251.19 | Professional | None | $114.82 | $162.18 | $251.19 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $1,995.26 | Facility | None | $288.40 | $426.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $134.90 Median $194.98 Typical High $239.88 | Professional | None | $134.90 | $194.98 | $239.88 |
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 $74.13 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $74.13 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.12 Typical High $34.67 | Professional | 55 · Aftercare only | $22.39 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $162.18 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $478.63 Typical High $478.63 | Professional | 50 · Both sides | $288.40 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $79.43 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $79.43 | $117.49 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $46.77 | Professional | 53 · Discontinued | $28.84 | $31.62 | $46.77 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $120.23 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $120.23 | $173.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $34.67 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $23.44 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $109.65 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $109.65 | $162.18 |
Where Michigan sits
The same service costs 4.1 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· 22nd of 51
$214
AK $513KY $126
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.