How much rates vary
Facilitymedian $2,570 · 10th to 90th $933 to $5,495Professionalmedian $891 · 10th to 90th $646 to $1,047
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 $891.25 Median $933.25 Typical High $6,918.31 | Facility | None | $891.25 | $933.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | None | $891.25 | $933.25 | $933.25 |
BCBS Michigan Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $4,466.84 | Facility | None | $2,511.89 | $2,570.40 | $4,466.84 |
BCBS Michigan Setting Professional Modifier None Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | None | $616.60 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,230.27 | Professional | None | $537.03 | $758.58 | $1,230.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,819.70 Median $4,073.80 Typical High $4,897.79 | Facility | None | $1,819.70 | $4,073.80 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,047.13 | Professional | None | $741.31 | $912.01 | $1,047.13 |
Priority Health Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,202.26 | Professional | None | $537.03 | $741.31 | $1,202.26 |
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 $741.31 Median $794.33 Typical High $912.01 | Professional | None | $741.31 | $794.33 | $912.01 |
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 $446.68 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $446.68 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $467.74 | $467.74 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $141.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Where Michigan sits
The same service costs 19.1 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· 28th of 51
$912
AK $2,884TX $151
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.