How much rates vary
Facilitymedian $3,236 · 10th to 90th $933 to $6,457Professionalmedian $851 · 10th to 90th $170 to $1,096
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 $758.58 Median $1,000.00 Typical High $5,754.40 | Facility | None | $758.58 | $1,000.00 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $977.24 | Professional | None | $758.58 | $794.33 | $977.24 |
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 $144.54 Median $512.86 Typical High $851.14 | Professional | None | $144.54 | $512.86 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,412.54 | Professional | None | $501.19 | $794.33 | $1,412.54 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $2,570.40 Typical High $5,754.40 | Facility | None | $977.24 | $2,570.40 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,122.02 | Professional | None | $812.83 | $1,023.29 | $1,122.02 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,122.02 | Professional | None | $457.09 | $758.58 | $1,122.02 |
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 $691.83 Median $851.14 Typical High $1,047.13 | Professional | None | $691.83 | $851.14 | $1,047.13 |
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 $380.19 Median $389.05 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $389.05 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $741.31 | Professional | 54 · Surgery only | $562.34 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $77.62 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $691.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $407.38 Typical High $537.03 | Professional | 52 · Reduced service | $389.05 | $407.38 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $154.88 | $162.18 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $794.33 | Professional | 54 · Surgery only | $588.84 | $616.60 | $794.33 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $158.49 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $158.49 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $107.15 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $107.15 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $741.31 |
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
$851
AK $3,020TX $490
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.