How much rates vary
Facilitymedian $3,236 · 10th to 90th $891 to $6,166Professionalmedian $550 · 10th to 90th $102 to $933
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 $457.09 Median $794.33 Typical High $4,897.79 | Facility | None | $457.09 | $794.33 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $776.25 | Professional | None | $457.09 | $575.44 | $776.25 |
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 $87.10 Median $323.59 Typical High $512.86 | Professional | None | $87.10 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $1,348.96 | Professional | None | $323.59 | $588.84 | $1,348.96 |
Health Alliance Plan Setting Facility Modifier None Typical Low $776.25 Median $2,570.40 Typical High $4,897.79 | Facility | None | $776.25 | $2,570.40 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $467.74 Median $794.33 Typical High $954.99 | Professional | None | $467.74 | $794.33 | $954.99 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $1,318.26 | Professional | None | $275.42 | $512.86 | $1,318.26 |
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 $416.87 Median $616.60 Typical High $954.99 | Professional | None | $416.87 | $616.60 | $954.99 |
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 $229.09 Median $288.40 Typical High $389.05 | Professional | 52 · Reduced service | $229.09 | $288.40 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $114.82 Typical High $154.88 | Professional | 53 · Discontinued | $91.20 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $436.52 Typical High $575.44 | Professional | 54 · Surgery only | $338.84 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $57.54 Typical High $77.62 | Professional | 56 · Pre-op care only | $45.71 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $407.38 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $316.23 | $407.38 | $537.03 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $281.84 Typical High $398.11 | Professional | 52 · Reduced service | $223.87 | $281.84 | $398.11 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $112.20 Typical High $158.49 | Professional | 53 · Discontinued | $89.13 | $112.20 | $158.49 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $416.87 Typical High $602.56 | Professional | 54 · Surgery only | $331.13 | $416.87 | $602.56 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $83.18 Typical High $120.23 | Professional | 55 · Aftercare only | $67.61 | $83.18 | $120.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $56.23 Typical High $79.43 | Professional | 56 · Pre-op care only | $44.67 | $56.23 | $79.43 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $389.05 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $309.03 | $389.05 | $562.34 |
Where Michigan sits
The same service costs 4.9 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· 26th of 51
$646
AK $1,862TX $380
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.