How much rates vary
Facilitymedian $631 · 10th to 90th $331 to $1,738Professionalmedian $562 · 10th to 90th $427 to $776
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 $436.52 Median $562.34 Typical High $4,897.79 | Facility | None | $436.52 | $562.34 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $562.34 | Professional | None | $436.52 | $436.52 | $562.34 |
BCBS Michigan Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,096.48 | Facility | None | $630.96 | $630.96 | $1,096.48 |
BCBS Michigan Setting Professional Modifier None Typical Low $309.03 Median $707.95 Typical High $741.31 | Professional | None | $309.03 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $660.69 | Professional | None | $302.00 | $426.58 | $660.69 |
Health Alliance Plan Setting Facility Modifier None Typical Low $251.19 Median $562.34 Typical High $4,897.79 | Facility | None | $251.19 | $562.34 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $794.33 | Professional | None | $426.58 | $588.84 | $794.33 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $588.84 | Professional | None | $302.00 | $426.58 | $588.84 |
United Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $3,019.95 | Facility | None | $288.40 | $426.58 | $3,019.95 |
United Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $758.58 | Professional | None | $436.52 | $575.44 | $758.58 |
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 $218.78 Median $218.78 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $309.03 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $302.00 | $309.03 | $398.11 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $213.80 | $281.84 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $85.11 | $112.20 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $316.23 | $416.87 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $83.18 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $56.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $389.05 |
Where Michigan sits
The same service costs 5.1 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· 19th of 51
$575
AK $1,514TX $295
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.