How much rates vary
Facilitymedian $3,236 · 10th to 90th $933 to $6,310Professionalmedian $871 · 10th to 90th $692 to $1,318
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 $933.25 Typical High $6,918.31 | Facility | None | $758.58 | $933.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $954.99 | Professional | None | $758.58 | $794.33 | $954.99 |
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 $524.81 Median $1,258.93 Typical High $1,318.26 | Professional | None | $524.81 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,380.38 | Professional | None | $512.86 | $776.25 | $1,380.38 |
Health Alliance Plan Setting Facility Modifier None Typical Low $977.24 Median $1,412.54 Typical High $4,897.79 | Facility | None | $977.24 | $1,412.54 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,047.13 | Professional | None | $758.58 | $933.25 | $1,047.13 |
Priority Health Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Priority Health Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,096.48 | Professional | None | $489.78 | $741.31 | $1,096.48 |
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 $676.08 Median $812.83 Typical High $977.24 | Professional | None | $676.08 | $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 $380.19 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $676.08 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $416.87 | $512.86 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $165.96 | $204.17 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $616.60 | $758.58 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $151.36 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $102.33 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $707.95 |
Where Michigan sits
The same service costs 6.6 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· 30th of 51
$871
AK $3,020TX $457
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.