How much rates vary
Facilitymedian $912 · 10th to 90th $550 to $2,291Professionalmedian $741 · 10th to 90th $537 to $955
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 $724.44 Median $891.25 Typical High $4,897.79 | Facility | None | $724.44 | $891.25 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $870.96 | Professional | None | $724.44 | $741.31 | $870.96 |
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 $147.91 Median $537.03 Typical High $870.96 | Professional | None | $147.91 | $537.03 | $870.96 |
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 $426.58 Median $707.95 Typical High $1,230.27 | Professional | None | $426.58 | $707.95 | $1,230.27 |
Health Alliance Plan Setting Facility Modifier None Typical Low $870.96 Median $1,819.70 Typical High $4,897.79 | Facility | None | $870.96 | $1,819.70 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $977.24 | Professional | None | $724.44 | $851.14 | $977.24 |
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 $426.58 Median $676.08 Typical High $1,000.00 | Professional | None | $426.58 | $676.08 | $1,000.00 |
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 $616.60 Median $724.44 Typical High $912.01 | Professional | None | $616.60 | $724.44 | $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 $354.81 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $616.60 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $380.19 | $457.09 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $151.36 | $181.97 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $575.44 | $676.08 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $138.04 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $91.20 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $630.96 |
Where Michigan sits
The same service costs 5.6 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· 29th of 51
$759
AK $2,399TX $427
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.