How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,072 to $6,166Professionalmedian $1,122 · 10th to 90th $813 to $1,738
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 $1,071.52 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,071.52 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,096.48 | $1,096.48 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,623.41 | Facility | None | $3,235.94 | $3,311.31 | $5,623.41 |
BCBS Michigan Setting Professional Modifier None Typical Low $245.47 Median $1,230.27 Typical High $1,862.09 | Professional | None | $245.47 | $1,230.27 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $2,570.40 | Professional | None | $630.96 | $1,071.52 | $2,570.40 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $4,897.79 | Facility | None | $2,238.72 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,288.25 | Professional | None | $912.01 | $1,122.02 | $1,288.25 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,479.11 | Professional | None | $630.96 | $1,000.00 | $1,479.11 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $7,943.28 | Facility | None | $851.14 | $2,238.72 | $7,943.28 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,148.15 | Professional | None | $912.01 | $1,023.29 | $1,148.15 |
13 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 $537.03 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $776.25 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 50 · Both sides | $1,995.26 | $1,995.26 | $1,995.26 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $229.09 | $229.09 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $851.14 | $851.14 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $169.82 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $112.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $794.33 |
Where Michigan sits
The same service costs 20.9 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· 32nd of 51
$1,122
AK $3,467TX $166
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.