How much rates vary
Facilitymedian $1,660 · 10th to 90th $457 to $3,388Professionalmedian $398 · 10th to 90th $316 to $501
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 $380.19 Median $457.09 Typical High $4,897.79 | Facility | None | $380.19 | $457.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $478.63 | Professional | None | $346.74 | $398.11 | $478.63 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,884.03 | Facility | None | $1,659.59 | $1,659.59 | $2,884.03 |
BCBS Michigan Setting Professional Modifier None Typical Low $57.54 Median $323.59 Typical High $489.78 | Professional | None | $57.54 | $323.59 | $489.78 |
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 $245.47 Median $331.13 Typical High $489.78 | Professional | None | $245.47 | $331.13 | $489.78 |
Health Alliance Plan Setting Facility Modifier None Typical Low $380.19 Median $1,047.13 Typical High $4,073.80 | Facility | None | $380.19 | $1,047.13 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $524.81 | Professional | None | $371.54 | $446.68 | $524.81 |
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 $245.47 Median $338.84 Typical High $489.78 | Professional | None | $245.47 | $338.84 | $489.78 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $501.19 | Professional | None | $338.84 | $398.11 | $501.19 |
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 $190.55 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $269.15 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $269.15 | $316.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $186.21 | $186.21 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $89.13 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | 54 · Surgery only | $275.42 | $275.42 | $331.13 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $309.03 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 28th of 51
$417
AK $1,549NJ $347
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.