How much rates vary
Facilitymedian $151 · 10th to 90th $112 to $871Professionalmedian $513 · 10th to 90th $389 to $708
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 $416.87 Median $524.81 Typical High $4,897.79 | Facility | None | $416.87 | $524.81 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | None | $416.87 | $426.58 | $524.81 |
BCBS Michigan Setting Facility Modifier None Typical Low $112.20 Median $114.82 Typical High $208.93 | Facility | None | $112.20 | $114.82 | $208.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $81.28 Median $707.95 Typical High $707.95 | Professional | None | $81.28 | $707.95 | $707.95 |
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 $257.04 Median $380.19 Typical High $512.86 | Professional | None | $257.04 | $380.19 | $512.86 |
Health Alliance Plan Setting Facility Modifier None Typical Low $154.88 Median $512.86 Typical High $4,897.79 | Facility | None | $154.88 | $512.86 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $645.65 | Professional | None | $407.38 | $512.86 | $645.65 |
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 $257.04 Median $389.05 Typical High $512.86 | Professional | None | $257.04 | $389.05 | $512.86 |
United Setting Facility Modifier None Typical Low $91.20 Median $177.83 Typical High $1,202.26 | Facility | None | $91.20 | $177.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $588.84 | Professional | None | $389.05 | $478.63 | $588.84 |
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 $208.93 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $371.54 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $204.17 | $257.04 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $102.33 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $309.03 | $389.05 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $77.62 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $51.29 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $363.08 |
Where Michigan sits
The same service costs 6.0 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
$501
AK $1,445TX $240
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.