How much rates vary
Facilitymedian $3,802 · 10th to 90th $813 to $6,607Professionalmedian $661 · 10th to 90th $138 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 $630.96 Median $4,897.79 Typical High $6,918.31 | Facility | None | $630.96 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
BCBS Michigan Setting Facility Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $6,606.93 | Facility | None | $3,801.89 | $3,890.45 | $6,606.93 |
BCBS Michigan Setting Professional Modifier None Typical Low $117.49 Median $1,000.00 Typical High $1,047.13 | Professional | None | $117.49 | $1,000.00 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,023.29 | Professional | None | $371.54 | $660.69 | $1,023.29 |
Health Alliance Plan Setting Facility Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $5,754.40 | Facility | None | $1,412.54 | $1,548.82 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $794.33 | Professional | None | $588.84 | $691.83 | $794.33 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $851.14 | Professional | None | $354.81 | $630.96 | $851.14 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $6,025.60 | Facility | None | $602.56 | $1,230.27 | $6,025.60 |
United Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $758.58 | Professional | None | $549.54 | $660.69 | $758.58 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $446.68 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $309.03 | $323.59 | $323.59 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $123.03 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $467.74 | $478.63 | $478.63 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $95.50 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $61.66 | $64.57 | $64.57 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $446.68 |
Where Michigan sits
The same service costs 18.2 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· 29th of 51
$676
AK $1,995TX $110
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.