How much rates vary
Facilitymedian $2,754 · 10th to 90th $550 to $4,786Professionalmedian $1,072 · 10th to 90th $724 to $1,445
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 $977.24 Median $1,202.26 Typical High $4,897.79 | Facility | None | $977.24 | $1,202.26 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,230.27 | Professional | None | $891.25 | $1,023.29 | $1,230.27 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $4,786.30 | Facility | None | $2,754.23 | $2,754.23 | $4,786.30 |
BCBS Michigan Setting Professional Modifier None Typical Low $181.97 Median $1,071.52 Typical High $1,659.59 | Professional | None | $181.97 | $1,071.52 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,174.90 | Professional | None | $616.60 | $912.01 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $4,897.79 | Facility | None | $954.99 | $1,479.11 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | None | $954.99 | $1,148.15 | $1,380.38 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,174.90 | Professional | None | $616.60 | $912.01 | $1,174.90 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,311.31 | Facility | None | $426.58 | $602.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,348.96 | Professional | None | $891.25 | $1,071.52 | $1,348.96 |
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 $478.63 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $831.76 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $575.44 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $190.55 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $707.95 | $870.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $173.78 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $812.83 |
Where Michigan sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$1,096
AK $3,311TX $741
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.