How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $3,981Professionalmedian $3,236 · 10th to 90th $2,570 to $5,495
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 $3,235.94 Median $3,235.94 Typical High $6,918.31 | Facility | None | $3,235.94 | $3,235.94 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,235.94 | Facility | None | $1,862.09 | $1,862.09 | $3,235.94 |
BCBS Michigan Setting Professional Modifier None Typical Low $724.44 Median $3,890.45 Typical High $5,495.41 | Professional | None | $724.44 | $3,890.45 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,570.40 | $3,801.89 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $7,413.10 | Facility | None | $1,202.26 | $3,162.28 | $7,413.10 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,630.78 | Professional | None | $2,570.40 | $3,162.28 | $3,630.78 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,398.83 | $3,890.45 |
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 $2,691.53 Median $3,019.95 Typical High $3,890.45 | Professional | None | $2,691.53 | $3,019.95 | $3,890.45 |
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,398.83 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,290.87 | $2,290.87 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $630.96 | $630.96 | $630.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,238.72 |
Where Michigan sits
The same service costs 15.8 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· 16th of 51
$3,236
AK $8,128TX $513
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.