How much rates vary
Facilitymedian $3,236 · 10th to 90th $537 to $5,495Professionalmedian $692 · 10th to 90th $417 to $1,072
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 $537.03 Median $891.25 Typical High $4,897.79 | Facility | None | $537.03 | $891.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $870.96 | Professional | None | $537.03 | $645.65 | $870.96 |
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 $416.87 Median $794.33 Typical High $1,071.52 | Professional | None | $416.87 | $794.33 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,071.52 | Professional | None | $371.54 | $616.60 | $1,071.52 |
Health Alliance Plan Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $4,897.79 | Facility | None | $912.01 | $1,513.56 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $954.99 | Professional | None | $588.84 | $776.25 | $954.99 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $1,000.00 | Professional | None | $371.54 | $537.03 | $1,000.00 |
United Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $5,248.07 | Facility | None | $426.58 | $602.56 | $5,248.07 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $794.33 | Professional | None | $371.54 | $616.60 | $794.33 |
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 $269.15 Median $323.59 Typical High $436.52 | Professional | 52 · Reduced service | $269.15 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 53 · Discontinued | $109.65 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $478.63 Typical High $660.69 | Professional | 54 · Surgery only | $407.38 | $478.63 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $87.10 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $446.68 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $380.19 | $446.68 | $616.60 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $295.12 Typical High $478.63 | Professional | 52 · Reduced service | $288.40 | $295.12 | $478.63 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $190.55 | Professional | 53 · Discontinued | $114.82 | $117.49 | $190.55 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $446.68 Typical High $707.95 | Professional | 54 · Surgery only | $426.58 | $446.68 | $707.95 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $141.25 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $141.25 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $95.50 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $95.50 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $416.87 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $398.11 | $416.87 | $660.69 |
Where Michigan sits
The same service costs 5.9 times more in Alaska than in Kentucky. 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· 27th of 51
$708
AK $2,138KY $363
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.