How much rates vary
Facilitymedian $1,122 · 10th to 90th $490 to $2,692Professionalmedian $339 · 10th to 90th $251 to $479
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 $281.84 Median $398.11 Typical High $4,897.79 | Facility | None | $281.84 | $398.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $416.87 | Professional | None | $281.84 | $309.03 | $416.87 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,995.26 | Facility | None | $1,122.02 | $1,148.15 | $1,995.26 |
BCBS Michigan Setting Professional Modifier None Typical Low $60.26 Median $316.23 Typical High $562.34 | Professional | None | $60.26 | $316.23 | $562.34 |
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 $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
Health Alliance Plan Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $4,897.79 | Facility | None | $389.05 | $954.99 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $457.09 | Professional | None | $275.42 | $389.05 | $457.09 |
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 $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $416.87 | Professional | None | $251.19 | $331.13 | $416.87 |
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 $141.25 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $218.78 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $204.17 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $204.17 | $275.42 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $141.25 | $194.98 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | 53 · Discontinued | $56.23 | $56.23 | $77.62 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $295.12 | Professional | 54 · Surgery only | $208.93 | $208.93 | $295.12 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $58.88 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $38.90 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $275.42 |
Where Michigan sits
The same service costs 4.0 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· 30th of 51
$347
AK $1,072KY $269
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.