How much rates vary
Facilitymedian $1,096 · 10th to 90th $457 to $2,818Professionalmedian $380 · 10th to 90th $186 to $513
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 $338.84 Median $457.09 Typical High $4,897.79 | Facility | None | $338.84 | $457.09 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $457.09 | Professional | None | $309.03 | $363.08 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,905.46 | Facility | None | $1,096.48 | $1,122.02 | $1,905.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $51.29 Median $275.42 Typical High $478.63 | Professional | None | $51.29 | $275.42 | $478.63 |
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 $234.42 Median $316.23 Typical High $436.52 | Professional | None | $234.42 | $316.23 | $436.52 |
Health Alliance Plan Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $4,897.79 | Facility | None | $346.74 | $954.99 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $524.81 | Professional | None | $331.13 | $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 $234.42 Median $316.23 Typical High $436.52 | Professional | None | $234.42 | $316.23 | $436.52 |
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 $309.03 Median $389.05 Typical High $489.78 | Professional | None | $309.03 | $389.05 | $489.78 |
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 $165.96 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $165.96 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $338.84 | Professional | 54 · Surgery only | $251.19 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $316.23 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | 52 · Reduced service | $165.96 | $165.96 | $223.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | 53 · Discontinued | $66.07 | $66.07 | $91.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | 54 · Surgery only | $245.47 | $245.47 | $338.84 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $67.61 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $44.67 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $316.23 |
Where Michigan sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 31st of 51
$398
AK $1,259UT $324
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.