How much rates vary
Facilitymedian $912 · 10th to 90th $525 to $2,291Professionalmedian $537 · 10th to 90th $302 to $724
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 $416.87 Median $645.65 Typical High $5,754.40 | Facility | None | $416.87 | $645.65 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $645.65 | Professional | None | $416.87 | $457.09 | $645.65 |
BCBS Michigan Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $1,548.82 | Facility | None | $891.25 | $912.01 | $1,548.82 |
BCBS Michigan Setting Professional Modifier None Typical Low $97.72 Median $724.44 Typical High $724.44 | Professional | None | $97.72 | $724.44 | $724.44 |
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 $269.15 Median $416.87 Typical High $912.01 | Professional | None | $269.15 | $416.87 | $912.01 |
Health Alliance Plan Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $4,897.79 | Facility | None | $630.96 | $1,230.27 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $676.08 | Professional | None | $436.52 | $616.60 | $676.08 |
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 $245.47 Median $398.11 Typical High $630.96 | Professional | None | $245.47 | $398.11 | $630.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $3,162.28 | Facility | None | $426.58 | $602.56 | $3,162.28 |
United Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $630.96 | Professional | None | $331.13 | $467.74 | $630.96 |
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 $208.93 Median $229.09 Typical High $323.59 | Professional | 52 · Reduced service | $208.93 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $128.82 | Professional | 53 · Discontinued | $83.18 | $91.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $489.78 | Professional | 54 · Surgery only | $316.23 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $97.72 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $457.09 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $213.80 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $213.80 | $331.13 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $131.83 | Professional | 53 · Discontinued | $83.18 | $87.10 | $131.83 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $323.59 | $489.78 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $100.00 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $66.07 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $66.07 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $302.00 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $302.00 | $457.09 |
Where Michigan sits
The same service costs 5.1 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· 22nd of 51
$550
AK $1,585TX $309
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.