How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,288 to $8,710Professionalmedian $3,090 · 10th to 90th $2,239 to $5,888
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 $3,630.78 Median $3,801.89 Typical High $6,918.31 | Facility | None | $3,630.78 | $3,801.89 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,630.78 | $3,801.89 | $3,801.89 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,897.79 Median $5,011.87 Typical High $8,709.64 | Facility | None | $4,897.79 | $5,011.87 | $8,709.64 |
BCBS Michigan Setting Professional Modifier None Typical Low $660.69 Median $3,890.45 Typical High $5,888.44 | Professional | None | $660.69 | $3,890.45 | $5,888.44 |
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 $2,187.76 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,187.76 | $3,090.30 | $4,365.16 |
Health Alliance Plan Setting Facility Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $6,606.93 | Facility | None | $3,311.31 | $3,801.89 | $6,606.93 |
Health Alliance Plan Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,238.72 | $2,884.03 | $3,801.89 |
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 $2,187.76 Median $2,884.03 Typical High $3,715.35 | Professional | None | $2,187.76 | $2,884.03 | $3,715.35 |
United Setting Facility Modifier None Typical Low $891.25 Median $2,818.38 Typical High $10,232.93 | Facility | None | $891.25 | $2,818.38 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,630.27 | $3,090.30 | $3,548.13 |
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 $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,819.70 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,691.53 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $363.08 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,630.27 | $2,630.27 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,819.70 | $1,905.46 | $1,905.46 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $724.44 | $758.58 | $758.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,754.23 | $2,818.38 | $2,818.38 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $363.08 | $380.19 | $380.19 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,630.27 | $2,630.27 |
Where Michigan sits
The same service costs 19.5 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· 33rd of 51
$3,162
AK $11,482TX $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.