How much rates vary
Facilitymedian $1,445 · 10th to 90th $550 to $2,951Professionalmedian $832 · 10th to 90th $589 to $1,122
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 $724.44 Median $912.01 Typical High $4,897.79 | Facility | None | $724.44 | $912.01 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $954.99 | Professional | None | $707.95 | $758.58 | $954.99 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,445.44 | $1,479.11 | $2,570.40 |
BCBS Michigan Setting Professional Modifier None Typical Low $165.96 Median $831.76 Typical High $1,288.25 | Professional | None | $165.96 | $831.76 | $1,288.25 |
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 $489.78 Median $630.96 Typical High $912.01 | Professional | None | $489.78 | $630.96 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $4,073.80 | Facility | None | $891.25 | $1,148.15 | $4,073.80 |
Health Alliance Plan Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,047.13 | Professional | None | $707.95 | $891.25 | $1,047.13 |
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 $489.78 Median $660.69 Typical High $912.01 | Professional | None | $489.78 | $660.69 | $912.01 |
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 $676.08 Median $794.33 Typical High $977.24 | Professional | None | $676.08 | $794.33 | $977.24 |
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 $363.08 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $630.96 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $354.81 | $446.68 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $141.25 | $177.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $537.03 | $660.69 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $134.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $89.13 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $616.60 |
Where Michigan sits
The same service costs 4.2 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· 26th of 51
$832
AK $2,455TX $589
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.