How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $7,079Professionalmedian $2,042 · 10th to 90th $457 to $2,291
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 $1,995.26 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,995.26 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,995.26 | $2,089.30 | $2,089.30 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,168.69 | $7,079.46 |
BCBS Michigan Setting Professional Modifier None Typical Low $389.05 Median $2,137.96 Typical High $2,290.87 | Professional | None | $389.05 | $2,137.96 | $2,290.87 |
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 $1,202.26 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,862.09 | $2,754.23 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,570.40 Median $4,265.80 Typical High $6,918.31 | Facility | None | $2,570.40 | $4,265.80 | $6,918.31 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,621.81 | $2,089.30 | $2,290.87 |
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 $1,202.26 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,659.59 | $2,691.53 |
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 $1,698.24 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,862.09 | $2,187.76 |
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 $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,445.44 | $1,445.44 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 50 · Both sides | $2,398.83 | $2,398.83 | $2,398.83 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $1,023.29 | $1,047.13 | $1,047.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,513.56 | $1,584.89 | $1,584.89 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $302.00 | $316.23 | $316.23 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $204.17 | $208.93 | $208.93 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,479.11 | $1,479.11 |
Where Michigan sits
The same service costs 20.0 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· 28th of 51
$2,042
AK $6,457TX $324
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.