How much rates vary
Facilitymedian $1,950 · 10th to 90th $794 to $4,571Professionalmedian $759 · 10th to 90th $151 to $977
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 $676.08 Median $812.83 Typical High $6,918.31 | Facility | None | $676.08 | $812.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $812.83 | Professional | None | $676.08 | $691.83 | $812.83 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Facility | None | $1,949.84 | $1,949.84 | $3,388.44 |
BCBS Michigan Setting Professional Modifier None Typical Low $128.82 Median $467.74 Typical High $758.58 | Professional | None | $128.82 | $467.74 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,174.90 | Professional | None | $436.52 | $724.44 | $1,174.90 |
Health Alliance Plan Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $6,918.31 | Facility | None | $794.33 | $1,412.54 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,000.00 | Professional | None | $691.83 | $831.76 | $1,000.00 |
Priority Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Priority Health Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,122.02 | Professional | None | $416.87 | $707.95 | $1,122.02 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,248.07 | Facility | None | $602.56 | $1,230.27 | $5,248.07 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $977.24 | Professional | None | $645.65 | $812.83 | $977.24 |
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 $338.84 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $562.34 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $346.74 | $416.87 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $138.04 | $165.96 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $524.81 | $616.60 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $123.03 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $83.18 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $575.44 |
Where Michigan sits
The same service costs 6.2 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
$759
AK $2,570TX $417
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.