How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $7,413Professionalmedian $1,738 · 10th to 90th $871 to $2,818
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 $1,737.80 Median $4,073.80 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
BCBS Michigan Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $7,413.10 | Facility | None | $4,265.80 | $4,265.80 | $7,413.10 |
BCBS Michigan Setting Professional Modifier None Typical Low $380.19 Median $2,041.74 Typical High $2,818.38 | Professional | None | $380.19 | $2,041.74 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,238.72 | Professional | None | $891.25 | $1,412.54 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,897.79 | Facility | None | $2,691.53 | $3,548.13 | $4,897.79 |
Health Alliance Plan Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,737.80 | $1,905.46 |
Priority Health Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Priority Health Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,819.70 | Professional | None | $891.25 | $1,348.96 | $1,819.70 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $8,912.51 | Facility | None | $851.14 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $1,819.70 | Professional | None | $870.96 | $1,479.11 | $1,819.70 |
13 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 $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 50 · Both sides | $3,019.95 | $3,019.95 | $3,019.95 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $354.81 | $354.81 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,348.96 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $269.15 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $177.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,258.93 |
Where Michigan sits
The same service costs 8.9 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· 23rd of 51
$1,778
AK $5,495TX $617
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.